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1. The KM3NeT potential for the next core-collapse supernova observation with neutrinos

Author

S. Aiello, A. Albert, S. Alves Garre, Z. Aly, A. Ambrosone, F. Ameli, M. Andre, G. Androulakis, M. Anghinolfi, M. Anguita, G. Anton, M. Ardid, S. Ardid, J. Aublin, C. Bagatelas, B. Baret, S. Basegmez du Pree, M. Bendahman, F. Benfenati, E. Berbee, A. M. van den Berg, V. Bertin, S. Biagi, M. Bissinger, M. Boettcher, M. Bou Cabo, J. Boumaaza, M. Bouta, M. Bouwhuis, C. Bozza, H. Brânzaş, R. Bruijn, J. Brunner, E. Buis, R. Buompane, J. Busto, B. Caiffi, D. Calvo, A. Capone, V. Carretero, P. Castaldi, S. Celli, M. Chabab, N. Chau, A. Chen, S. Cherubini, V. Chiarella, T. Chiarusi, M. Circella, R. Cocimano, J. A. B. Coelho, A. Coleiro, M. Colomer Molla, R. Coniglione, P. Coyle, A. Creusot, G. Cuttone, R. Dallier, B. De Martino, M. De Palma, M. Di Marino, I. Di Palma, A. F. Díaz, D. Diego-Tortosa, C. Distefano, A. Domi, C. Donzaud, D. Dornic, M. Dörr, D. Drouhin, T. Eberl, A. Eddyamoui, T. van Eeden, D. van Eijk, I. El Bojaddaini, D. Elsaesser, A. Enzenhöfer, V. Espinosa, P. Fermani, G. Ferrara, M. D. Filipović, F. Filippini, L. A. Fusco, O. Gabella, T. Gal, A. Garcia Soto, F. Garufi, Y. Gatelet, N. Geißelbrecht, L. Gialanella, E. Giorgio, S. R. Gozzini, R. Gracia, K. Graf, D. Grasso, G. Grella, D. Guderian, C. Guidi, J. Haefner, H. Hamdaoui, H. van Haren, A. Heijboer, A. Hekalo, L. Hennig, J. J. Hernández-Rey, J. Hofestädt, F. Huang, W. Idrissi Ibnsalih, G. Illuminati, C. W. James, M. de Jong, P. de Jong, B. J. Jung, M. Kadler, P. Kalaczyński, O. Kalekin, U. F. Katz, N. R. Khan Chowdhury, G. Kistauri, F. van der Knaap, P. Kooijman, A. Kouchner, M. Kreter, V. Kulikovskiy, R. Lahmann, M. Lamoureux, G. Larosa, R. Le Breton, S. Le Stum, O. Leonardi, F. Leone, E. Leonora, N. Lessing, G. Levi, M. Lincetto, M. Lindsey Clark, T. Lipreau, F. Longhitano, D. Lopez-Coto, L. Maderer, J. Mańczak, K. Mannheim, A. Margiotta, A. Marinelli, C. Markou, L. Martin, J. A. Martínez-Mora, A. Martini, F. Marzaioli, S. Mastroianni, S. Mazzou, K. W. Melis, G. Miele, P. Migliozzi, E. Migneco, P. Mijakowski, L. S. Miranda, C. M. Mollo, M. Morganti, M. Moser, A. Moussa, R. Muller, M. Musumeci, L. Nauta, S. Navas, C. A. Nicolau, B. Ó Fearraigh, M. O’Sullivan, M. Organokov, A. Orlando, J. Palacios González, G. Papalashvili, R. Papaleo, G. Passaro, C. Pastore, A. M. Păun, G. E. Păvălaş, C. Pellegrino, M. Perrin-Terrin, V. Pestel, P. Piattelli, C. Pieterse, K. Pikounis, O. Pisanti, C. Poirè, V. Popa, T. Pradier, G. Pühlhofer, S. Pulvirenti, O. Rabyang, F. Raffaelli, N. Randazzo, S. Razzaque, D. Real, S. Reck, G. Riccobene, S. Rivoire, A. Romanov, A. Rovelli, F. Salesa Greus, D. F. E. Samtleben, A. Sánchez Losa, M. Sanguineti, A. Santangelo, D. Santonocito, P. Sapienza, J. Schnabel, M. F. Schneider, J. Schumann, H. M. Schutte, J. Seneca, I. Sgura, R. Shanidze, A. Sharma, F. Simeone, A. Sinopoulou, B. Spisso, M. Spurio, D. Stavropoulos, S. M. Stellacci, M. Taiuti, Y. Tayalati, E. Tenllado, T. Thakore, H. Thiersen, S. Tingay, V. Tsourapis, E. Tzamariudaki, D. Tzanetatos, T. Unbehaun, V. Van Elewyck, G. Vannoye, G. Vasileiadis, F. Versari, S. Viola, D. Vivolo, G. de Wasseige, J. Wilms, R. Wojaczyński, E. de Wolf, S. Zavatarelli, A. Zegarelli, D. Zito, J. D. Zornoza, J. Zúñiga, and N. Zywucka

Subjects
Astrophysics, QB460-466, Nuclear and particle physics. Atomic energy. Radioactivity, QC770-798
Abstract

Abstract The KM3NeT research infrastructure is under construction in the Mediterranean Sea. It consists of two water Cherenkov neutrino detectors, ARCA and ORCA, aimed at neutrino astrophysics and oscillation research, respectively. Instrumenting a large volume of sea water with $$\sim {6200}$$ ∼ 6200 optical modules comprising a total of $$\sim {200{,}000}$$ ∼ 200 , 000 photomultiplier tubes, KM3NeT will achieve sensitivity to $$\sim {10} \ \mathrm{MeV}$$ ∼ 10 MeV neutrinos from Galactic and near-Galactic core-collapse supernovae through the observation of coincident hits in photomultipliers above the background. In this paper, the sensitivity of KM3NeT to a supernova explosion is estimated from detailed analyses of background data from the first KM3NeT detection units and simulations of the neutrino signal. The KM3NeT observational horizon (for a $$5\,\sigma $$ 5 σ discovery) covers essentially the Milky-Way and for the most optimistic model, extends to the Small Magellanic Cloud ( $$\sim {60} \ \mathrm{kpc}$$ ∼ 60 kpc ). Detailed studies of the time profile of the neutrino signal allow assessment of the KM3NeT capability to determine the arrival time of the neutrino burst with a few milliseconds precision for sources up to 5–8 kpc away, and detecting the peculiar signature of the standing accretion shock instability if the core-collapse supernova explosion happens closer than 3–5 kpc, depending on the progenitor mass. KM3NeT’s capability to measure the neutrino flux spectral parameters is also presented.

Published
2021
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2. Dependence of atmospheric muon flux on seawater depth measured with the first KM3NeT detection units

Author

M. Ageron, S. Aiello, F. Ameli, M. Andre, G. Androulakis, M. Anghinolfi, G. Anton, M. Ardid, J. Aublin, C. Bagatelas, G. Barbarino, B. Baret, S. Basegmez du Pree, A. Belias, E. Berbee, A. M. van den Berg, V. Bertin, V. van Beveren, S. Biagi, A. Biagioni, S. Bianucci, M. Billault, M. Bissinger, R. de Boer, J. Boumaaza, S. Bourret, M. Bouta, M. Bouwhuis, C. Bozza, H. Brânzaş, M. Briel, M. Bruchner, R. Bruijn, J. Brunner, E. Buis, R. Buompane, J. Busto, G. Cacopardo, L. Caillat, C. Calì, D. Calvo, A. Capone, S. Celli, M. Chabab, N. Chau, S. Cherubini, V. Chiarella, T. Chiarusi, M. Circella, R. Cocimano, J. A. B. Coelho, A. Coleiro, M. Colomer Molla, S. Colonges, R. Coniglione, A. Cosquer, P. Coyle, A. Creusot, G. Cuttone, C. D’Amato, A. D’Amico, A. D’Onofrio, R. Dallier, M. De Palma, C. De Sio, I. Di Palma, A. F. Díaz, D. Diego-Tortosa, C. Distefano, A. Domi, R. Donà, C. Donzaud, L. van Dooren, D. Dornic, M. Dörr, M. Durocher, T. Eberl, T. van Eeden, I. El Bojaddaini, H. Eljarrari, D. Elsaesser, A. Enzenhöfer, P. Fermani, G. Ferrara, M. D. Filipović, L. A. Fusco, D. Gajanana, T. Gal, A. Garcia Soto, F. Garufi, L. Gialanella, E. Giorgio, A. Giuliante, S. R. Gozzini, R. Gracia, K. Graf, D. Grasso, T. Grégoire, G. Grella, A. Grimaldi, A. Grmek, D. Guderian, M. Guerzoni, C. Guidi, S. Hallmann, H. Hamdaoui, H. van Haren, A. Heijboer, A. Hekalo, S. Henry, J. J. Hernández-Rey, J. Hofestädt, F. Huang, E. Huesca Santiago, G. Illuminati, C. W. James, P. Jansweijer, M. Jongen, M. de Jong, P. de Jong, M. Kadler, P. Kalaczyński, O. Kalekin, U. F. Katz, F. Kayzel, P. Keller, N. R. Khan Chowdhury, F. van der Knaap, E. N. Koffeman, P. Kooijman, J. Koopstra, A. Kouchner, M. Kreter, V. Kulikovskiy, K. K. Meghna, R. Lahmann, P. Lamare, G. Larosa, J. Laurence, R. Le Breton, F. Leone, E. Leonora, G. Levi, F. Librizzi, M. Lincetto, P. Litrico, C. D. Llorens Alvarez, A. Lonardo, F. Longhitano, D. Lopez-Coto, G. Maggi, J. Mańczak, K. Mannheim, A. Margiotta, A. Marinelli, C. Markou, L. Martin, J. A. Martínez-Mora, A. Martini, F. Marzaioli, R. Mele, K. W. Melis, P. Migliozzi, E. Migneco, P. Mijakowski, L. S. Miranda, C. M. Mollo, M. Mongelli, M. Morganti, M. Moser, A. Moussa, R. Muller, P. Musico, M. Musumeci, L. Nauta, S. Navas, C. A. Nicolau, C. Nielsen, B. Ó Fearraigh, M. Organokov, A. Orlando, V. Panagopoulos, G. Pancaldi, G. Papalashvili, R. Papaleo, C. Pastore, G. E. Păvălaş, G. Pellegrini, C. Pellegrino, M. Perrin-Terrin, P. Piattelli, K. Pikounis, O. Pisanti, C. Poirè, G. Polydefki, V. Popa, M. Post, T. Pradier, G. Pühlhofer, S. Pulvirenti, L. Quinn, F. Raffaelli, N. Randazzo, A. Rapicavoli, S. Razzaque, D. Real, S. Reck, J. Reubelt, G. Riccobene, L. Rigalleau, G. Rizza, R. Rocco, A. Rovelli, J. Royon, M. Salemi, I. Salvadori, D. F. E. Samtleben, A. Sánchez Losa, M. Sanguineti, A. Santangelo, D. Santonocito, P. Sapienza, J. Schmelling, V. Sciacca, D. Sciliberto, J. Seneca, I. Sgura, R. Shanidze, A. Sharma, F. Simeone, A. Sinopoulou, B. Spisso, M. Spurio, D. Stavropoulos, J. Steijger, S. M. Stellacci, B. Strandberg, D. Stransky, T. Stüven, M. Taiuti, Y. Tayalati, E. Tenllado, D. Tézier, T. Thakore, S. Theraube, P. Timmer, S. Tingay, A. Trovato, S. Tsagkli, E. Tzamariudaki, D. Tzanetatos, C. Valieri, V. Van Elewyck, F. Versari, S. Viola, D. Vivolo, G. de Wasseige, J. Wilms, R. Wojaczyński, E. de Wolf, D. Zaborov, A. Zegarelli, J. D. Zornoza, and J. Zúñiga

Subjects
Astrophysics, QB460-466, Nuclear and particle physics. Atomic energy. Radioactivity, QC770-798
Abstract

Abstract KM3NeT is a research infrastructure located in the Mediterranean Sea, that will consist of two deep-sea Cherenkov neutrino detectors. With one detector (ARCA), the KM3NeT Collaboration aims at identifying and studying TeV–PeV astrophysical neutrino sources. With the other detector (ORCA), the neutrino mass ordering will be determined by studying GeV-scale atmospheric neutrino oscillations. The first KM3NeT detection units were deployed at the Italian and French sites between 2015 and 2017. In this paper, a description of the detector is presented, together with a summary of the procedures used to calibrate the detector in-situ. Finally, the measurement of the atmospheric muon flux between 2232–3386 m seawater depth is obtained.

Published
2020
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3. Intrinsic limits on resolutions in muon- and electron-neutrino charged-current events in the KM3NeT/ORCA detector

Author

The KM3NeT collaboration, S. Adrián-Martínez, M. Ageron, S. Aiello, A. Albert, F. Ameli, E. G. Anassontzis, M. Andre, G. Androulakis, M. Anghinolfi, G. Anton, M. Ardid, T. Avgitas, G. Barbarino, E. Barbarito, B. Baret, J. Barrios-Mart, A. Belias, E. Berbee, A. van den Berg, V. Bertin, S. Beurthey, V. van Beveren, N. Beverini, S. Biagi, A. Biagioni, M. Billault, M. Bondì, R. Bormuth, B. Bouhadef, G. Bourlis, S. Bourret, C. Boutonnet, M. Bouwhuis, C. Bozza, R. Bruijn, J. Brunner, E. Buis, R. Buompane, J. Busto, G. Cacopardo, L. Caillat, M. Calamai, D. Calvo, A. Capone, L. Caramete, S. Cecchini, S. Celli, C. Champion, S. Cherubini, V. Chiarella, L. Chiarelli, T. Chiarusi, M. Circella, L. Classen, D. Cobas, R. Cocimano, J. A. B. Coelho, A. Coleiro, S. Colonges, R. Coniglione, M. Cordelli, A. Cosquer, P. Coyle, A. Creusot, G. Cuttone, C. D’Amato, A. D’Amico, A. D’Onofrio, G. De Bonis, C. De Sio, I. Di Palma, A. F. Díaz, C. Distefano, C. Donzaud, D. Dornic, Q. Dorosti-Hasankiadeh, E. Drakopoulou, D. Drouhin, M. Durocher, T. Eberl, S. Eichie, D. van Eijk, I. El Bojaddaini, D. Elsaesser, A. Enzenhöfer, M. Favaro, P. Fermani, G. Ferrara, G. Frascadore, M. Furini, L. A. Fusco, T. Gal, S. Galatà, F. Garufi, P. Gay, M. Gebyehu, F. Giacomini, L. Gialanella, V. Giordano, N. Gizani, R. Gracia, K. Graf, T. Grégoire, G. Grella, A. Grmek, M. Guerzoni, R. Habel, S. Hallmann, H. van Haren, S. Harissopulos, T. Heid, A. Heijboer, E. Heine, S. Henry, J. J. Hernández-Rey, M. Hevinga, J. Hofestädt, C. M. F. Hugon, G. Illuminati, C. W. James, P. Jansweijerf, M. Jongen, M. de Jong, M. Kadler, O. Kalekin, A. Kappes, U. F. Katz, P. Keller, G. Kieft, D. Kießling, E. N. Koffeman, P. Kooijman, A. Kouchner, M. Kreter, V. Kulikovskiy, R. Lahmann, P. Lamare, G. Larosa, A. Leisos, F. Leone, E. Leonora, M. Lindsey Clark, A. Liolios, C. D. Llorens Alvarez, D. Lo Presti, H. Löhner, A. Lonardo, M. Lotze, S. Loucatos, E. Maccioni, K. Mannheim, M. Manzali, A. Margiotta, A. Margotti, A. Marinelli, O. Maris, C. Markou, J. A. Martínez-Mora, A. Martini, F. Marzaioli, R. Mele, K. W. Melis, T. Michael, P. Migliozzi, E. Migneco, P. Mijakowski, A. Miraglia, C. M. Mollo, M. Mongelli, M. Morganti, A. Moussa, P. Musico, M. Musumeci, S. Navas, C. A. Nicolau, I. Olcina, C. Olivetto, A. Orlando, A. Orzelli, G. Pancaldi, A. Papaikonomou, R. Papaleo, G. E. Păvălas, H. Peek, G. Pellegrini, C. Pellegrino, C. Perrina, M. Pfutzner, P. Piattelli, K. Pikounis, M.-O. Pleinert, G. E. Poma, V. Popa, T. Pradier, F. Pratolongo, G. Pühlhofer, S. Pulvirenti, L. Quinn, C. Racca, F. Raffaelli, N. Randazzo, T. Rauch, D. Real, L. Resvanis, J. Reubelt, G. Riccobene, C. Rossi, A. Rovelli, M. Saldaña, I. Salvadori, D. F. E. Samtleben, A. Sánchez García, A. Sánchez Losa, M. Sanguineti, A. Santangelo, D. Santonocito, P. Sapienza, F. Schimmel, J. Schmelling, J. Schnabel, V. Sciacca, M. Sedita, T. Seitz, I. Sgura, F. Simeone, V. Sipala, B. Spisso, M. Spurio, G. Stavropoulos, J. Steijger, S. M. Stellacci, D. Stransky, M. Taiuti, Y. Tayalati, F. Terrasi, D. Tézier, S. Theraube, P. Timmer, C. Tönnis, L. Trasatti, R. Travaglini, A. Trovato, A. Tsirigotis, S. Tzamarias, E. Tzamariudaki, B. Vallage, V. Van Elewyck, J. Vermeulen, F. Versari, P. Vicini, S. Viola, D. Vivolo, M. Volkert, L. Wiggers, J. Wilms, E. de Wolf, K. Zachariadou, S. Zani, J. D. Zornoza, and J. Zúñiga

Subjects
Neutrino Detectors and Telescopes (experiments), Nuclear and particle physics. Atomic energy. Radioactivity, QC770-798
Abstract

Abstract Studying atmospheric neutrino oscillations in the few-GeV range with a multi-megaton detector promises to determine the neutrino mass hierarchy. This is the main science goal pursued by the future KM3NeT/ORCA water Cherenkov detector in the Mediterranean Sea. In this paper, the processes that limit the obtainable resolution in both energy and direction in charged-current neutrino events in the ORCA detector are investigated. These processes include the composition of the hadronic fragmentation products, the subsequent particle propagation and the photon-sampling fraction of the detector. GEANT simulations of neutrino interactions in seawater produced by GENIE are used to study the effects in the 1-20 GeV range. It is found that fluctuations in the hadronic cascade in conjunction with the variation of the inelasticity y are most detrimental to the resolutions. The effect of limited photon sampling in the detector is of significantly less importance. These results will therefore also be applicable to similar detectors/media, such as those in ice.

Published
2017
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4. Determination of fumonisin content in maize using near-infrared hyperspectral imaging (NIR-HSI) technology and chemometric methods

Author

R. R. P. Conceição, V. A. V. Queiroz, E. P. Medeiros, J. B. Araújo, D. D. S. Araújo, R. A. Miguel, M. A. R. Stoianoff, and M. L. F. Simeone

Subjects
Zea mays L., mycotoxins, fumonisins, non-destructive analysis, hyperspectral image near infrared, partial least squares (PLS), Science, Biology (General), QH301-705.5, Zoology, QL1-991, Botany, QK1-989
Abstract

Abstract Maize (Zea mays L.) is of socioeconomic importance as an essential food for human and animal nutrition. However, cereals are susceptible to attack by mycotoxin-producing fungi, which can damage health. The methods most commonly used to detect and quantify mycotoxins are expensive and time-consuming. Therefore, alternative non-destructive methods are required urgently. The present study aimed to use near-infrared spectroscopy with hyperspectral imaging (NIR-HSI) and multivariate image analysis to develop a rapid and accurate method for quantifying fumonisins in whole grains of six naturally contaminated maize cultivars. Fifty-eight samples, each containing 40 grains, were subjected to NIR-HSI. These were subsequently divided into calibration (38 samples) and prediction sets (20 samples) based on the multispectral data obtained. The averaged spectra were subjected to various pre-processing techniques (standard normal variate (SNV), first derivative, or second derivative). The most effective pre-treatment performed on the spectra was SNV. Partial least squares (PLS) models were developed to quantify the fumonisin content. The final model presented a correlation coefficient (R2) of 0.98 and root mean square error of calibration (RMSEC) of 508 µg.kg-1 for the calibration set, an R2 of 0.95 and root mean square error of prediction (RMSEP) of 508 µg.kg-1 for the test validation set and a ratio of performance to deviation of 4.7. It was concluded that NIR-HSI with partial least square regression is a rapid, effective, and non-destructive method to determine the fumonisin content in whole maize grains.

Published
2024
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5. Resistência de híbridos de sorgo energia bmr à broca-da-cana-de-açúcar e lagarta-do-cartucho

Author

C. S. F. Souza, B. H. S. Souza, R. A. C. Parrella, M. L. F. Simeone, P. T. Nascimento, J. C. O. França, P. F. Lima, S. M. Mendes, Universidade Federal de Lavras, RAFAEL AUGUSTO DA COSTA PARRELLA, CNPMS, MARIA LUCIA FERREIRA SIMEONE, CNPMS, Universidade Federal de São João del-Rei, and SIMONE MARTINS MENDES, CNPMS.

Subjects
QH301-705.5, Science, Diatraea saccharalis, Sorgo, resistência de plantas, Biomass, Greenhouse, Moths, Spodoptera, complex mixtures, chemistry.chemical_compound, Animals, Diatraea Saccharalis, Lignin, Biology (General), Sorghum, Hybrid, biology, Cana de Açúcar, energy sorghum, fungi, Botany, food and beverages, Spodoptera frugiperda, biology.organism_classification, plant resistance, Saccharum, Resistência de planta, QL1-991, Praga de Planta, chemistry, Agronomy, Biofuel, Larva, QK1-989, sorgo energia, Fall armyworm, General Agricultural and Biological Sciences, Zoology, Spodoptera Frugiperda
Abstract

The lower lignin content in plants species with energy potential results in easier cellulose breakdown, making glucose available for ethanol generation. However, higher lignin levels can increase resistance to insect attack. The objective of this work was to evaluate the susceptibility of a bmr-6 biomass sorghum (a mutant genotype with a lower concentration of lignin) to important pests of energy sorghum, Diatraea saccharalis and Spodoptera frugiperda. Experiments were performed in the laboratory and greenhouse to evaluate the development of these pests on the biomass sorghum bmr hybrids BR007, BR008, and TX635 and their respective conventional near-isogenic genotypes (without the bmr gene). The lignin content was higher in non-bmr hybrids, but the evaluated insect variables varied between treatments, not being consistent in just one hybrid or because it is bmr or not. The lowest survival of S. frugiperda was observed in the BR008 hybrid, both bmr and non-bmr. The S. frugiperda injury scores on plants in the greenhouse were high (>7) in all treatments. For D. saccharalis, there was no difference in larval survival in the laboratory, but in the greenhouse, the BR007 hybrid, both bmr and non-bmr, provided greater survival. Due the need to diversify the energy matrix and the fact that greater susceptibility of the bmr hybrids to either pests was not found in this study, these results hold promise for cultivation of these biomass sorghum hybrids for the production of biofuels. Resumo O menor teor de lignina em espécies de plantas com potencial energético resulta na maior facilidade de quebra da celulose, disponibilizando glicose para geração de etanol. Porém, maiores teores de lignina representa um fator de resistência ao ataque de insetos. O objetivo deste trabalho foi avaliar como importantes pragas do sorgo energia, Diatraea saccharalis e Spodoptera frugiperda, se comportam quanto à alimentação e desempenho em sorgo bmr-6, um genótipo mutante com menor concentração de lignina. Foram realizados experimentos em laboratório e casa de vegetação, avaliando o desenvolvimento destas pragas nos híbridos de sorgo biomassa bmr 007, 008, TX635 e seus respectivos genótipos isogênicos convencionais (sem o gene bmr). O teor de lignina foi maior nos híbridos não bmr, mas nos parâmetros avaliados nos insetos, houve variação entre os tratamentos, não sendo consistente em apenas um híbrido e nem por ser ou não bmr. A menor sobrevivência de S. frugiperda foi verificada no híbrido BR008 tanto bmr quanto não bmr. As notas de injúria por S. frugiperda no sorgo em casa de vegetação foram altas (>7) em todos os tratamentos. Para D. saccharalis, não houve diferença significativa para a sobrevivência larval em laboratório, mas em casa de vegetação o híbrido BR007 tanto bmr quanto não bmr proporcionaram maior sobrevivência. Diante da necessidade de diversificar a matriz energética e o fato de que não foi comprovada neste estudo maior suscetibilidade dos híbridos bmr a ambas as pragas, estes resultados são promissores para o cultivo desses híbridos de sorgo biomassa para produção de biocombustíveis.

Published
2024
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6. Abdominal Imaging Findings in COVID-19: Preliminary Observations

Author

Michael A. Blake, Joseph F. Simeone, Mark Anderson, Peter F. Hahn, Matthew D. Li, Michael S. Gee, Susanna I. Lee, Avinash Kambadakone, Amirkasra Mojtahed, Aoife Kilcoyne, Sanjay Saini, Mukesh G. Harisinghani, George C. Velmahos, Theodore T. Pierce, Anthony E. Samir, Debra A. Gervais, David A. Rosman, Denston Carey, Joseph Misdraji, Rajesh Bhayana, Avik Som, Pari V. Pandharipande, and Onofrio A. Catalano

Subjects
Adult, Male, medicine.medical_specialty, Adolescent, Gastrointestinal Diseases, medicine.medical_treatment, Pneumonia, Viral, Gastroenterology, 030218 nuclear medicine & medical imaging, law.invention, Thoracic Imaging, 03 medical and health sciences, Betacoronavirus, Young Adult, 0302 clinical medicine, law, Internal medicine, Laparotomy, Abdomen, medicine, Humans, Radiology, Nuclear Medicine and imaging, Pandemics, Original Research, Aged, Retrospective Studies, Aged, 80 and over, Lung, Bowel infarction, business.industry, SARS-CoV-2, Gallbladder, COVID-19, Retrospective cohort study, Middle Aged, medicine.disease, Thrombosis, Intensive care unit, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Cholecystostomy, Female, business, Coronavirus Infections
Abstract

Background Angiotensin-converting enzyme 2, a target of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), demonstrates its highest surface expression in the lung, small bowel, and vasculature, suggesting abdominal viscera may be susceptible to injury. Purpose To report abdominal imaging findings in patients with coronavirus disease 2019. Materials and Methods In this retrospective cross-sectional study, patients consecutively admitted to a single quaternary care center from March 27 to April 10, 2020, who tested positive for SARS-CoV-2 were included. Abdominal imaging studies performed in these patients were reviewed, and salient findings were recorded. Medical records were reviewed for clinical data. Univariable analysis and logistic regression were performed. Results A total of 412 patients (average age, 57 years; range, 18 to >90 years; 241 men, 171 women) were evaluated. A total of 224 abdominal imaging studies were performed (radiography, n = 137; US, n = 44; CT, n = 42; MRI, n = 1) in 134 patients (33%). Abdominal imaging was associated with age (odds ratio [OR], 1.03 per year of increase; P = .001) and intensive care unit (ICU) admission (OR, 17.3; P < .001). Bowel-wall abnormalities were seen on 31% of CT images (13 of 42) and were associated with ICU admission (OR, 15.5; P = .01). Bowel findings included pneumatosis or portal venous gas, seen on 20% of CT images obtained in patients in the ICU (four of 20). Surgical correlation (n = 4) revealed unusual yellow discoloration of the bowel (n = 3) and bowel infarction (n = 2). Pathologic findings revealed ischemic enteritis with patchy necrosis and fibrin thrombi in arterioles (n = 2). Right upper quadrant US examinations were mostly performed because of liver laboratory findings (87%, 32 of 37), and 54% (20 of 37) revealed a dilated sludge-filled gallbladder, suggestive of bile stasis. Patients with a cholecystostomy tube placed (n = 4) had negative bacterial cultures. Conclusion Bowel abnormalities and gallbladder bile stasis were common findings on abdominal images of patients with coronavirus disease 2019. Patients who underwent laparotomy often had ischemia, possibly due to small-vessel thrombosis. © RSNA, 2020.

Published
2020

9. Visual and Hearing Impairment Are Associated With Delirium in Hospitalized Patients: Results of a Multisite Prevalence Study

Author

Alessandro Morandi, Marco Inzitari, Cristina Udina, Neus Gual, Miriam Mota, Elena Tassistro, Anita Andreano, Antonio Cherubini, Simona Gentile, Enrico Mossello, Alessandra Marengoni, Anna Olivé, Francesc Riba, Domingo Ruiz, Elisabet de Jaime, Giuseppe Bellelli, A. Tarasconi, M. Sella, S. Auriemma, G. Paternò, G. Faggian, C. Lucarelli, N. De Grazia, C. Alberto, A. Margola, L. Porcella, I. Nardiello, E. Chimenti, M. Zeni, A. Giani, S. Famularo, E. Romairone, C. Minaglia, C. Ceccotti, G. Guerra, G. Mantovani, F. Monacelli, T. Candiani, A. Ballestrero, F. Santolini, M. Rosso, V. Bono, S. Sibilla, P. Dal Santo, M. Ceci, P. Barone, T. Schirinzi, A. Formenti, G. Nastasi, G. Isaia, D. Gonella, A. Battuello, S. Casson, D. Calvani, F. Boni, A. Ciaccio, R. Rosa, G. Sanna, S. Manfredini, L. Cortese, M. Rizzo, R. Prestano, A. Greco, M. Lauriola, G. Gelosa, V. Piras, M. Arena, D. Cosenza, A. Bellomo, M. LaMontagna, L. Gabbani, L. Lambertucci, S. Perego, G. Parati, G. Basile, V. Gallina, G. Pilone, C. Giudice, F. De, L. Pietrogrande, B. De, M. Mosca, I. Corazzin, P. Rossi, V. Nunziata, F. D'Amico, A. Grippa, S. Giardini, R. Barucci, A. Cossu, L. Fiorin, M. Distefano, M. Lunardelli, M. Brunori, I. Ruffini, E. Abraham, A. Varutti, E. Fabbro, A. Catalano, G. Martino, D. Leotta, A. Marchet, G. Dell'Aquila, A. Scrimieri, M. Davoli, M. Casella, A. Cartei, G. Polidori, D. Brischetto, S. Motta, R. Saponara, P. Perrone, G. Russo, D. Del, C. Car, T. Pirina, S. Franzoni, A. Cotroneo, F. Ghiggia, G. Volpi, C. Menichetti, M. Bo, A. Panico, P. Calogero, G. Corvalli, M. Mauri, E. Lupia, R. Manfredini, F. Fabbian, A. March, M. Pedrotti, M. Veronesi, E. Strocchi, C. Borghi, A. Bianchetti, A. Crucitti, V. DiFrancesco, G. Fontana, L. Bonanni, F. Barbone, C. Serrati, G. Ballardini, M. Simoncelli, G. Ceschia, C. Scarpa, R. Brugiolo, S. Fusco, T. Ciarambino, C. Biagini, E. Tonon, M. Porta, D. Venuti, M. DelSette, M. Poeta, G. Barbagallo, G. Trovato, A. Delitala, P. Arosio, F. Reggiani, G. Zuliani, B. Ortolani, E. Mussio, A. Girardi, A. Coin, G. Ruotolo, A. Castagna, M. Masina, R. Cimino, A. Pinciaroli, G. Tripodi, U. Cannistrà, F. Cassadonte, M. Vatrano, L. Scaglione, P. Fogliacco, C. Muzzuilini, F. Romano, A. Padovani, L. Rozzini, A. Cagnin, F. Fragiacomo, G. Desideri, E. Liberatore, A. Bruni, G. Orsitto, M. Franco, L. Bonfrate, M. Bonetto, N. Pizio, G. Magnani, G. Cecchetti, A. Longo, V. Bubba, L. Marinan, M. Cotelli, M. Turla, M. Sessa, L. Abruzzi, G. Castoldi, D. LoVetere, C. Musacchio, M. Novello, A. Cavarape, A. Bini, A. Leonardi, F. Seneci, W. Grimaldi, F. Fimognari, V. Bambara, A. Saitta, F. Corica, M. Braga, E. Ettorre, C. Camellini, G. Bellelli, G. Annoni, A. Marengoni, A. Crescenzo, G. Noro, R. Turco, M. Ponzetto, L. Giuseppe, B. Mazzei, G. Maiuri, D. Costaggiu, R. Damato, M. Formilan, G. Patrizia, M. Gallucci, M. Paragona, P. Bini, D. Modica, C. Abati, M. Clerici, I. Barbera, F. NigroImperiale, A. Manni, C. Votino, C. Castiglioni, M. Di, M. Degl'Innocenti, G. Moscatelli, S. Guerini, C. Casini, D. Dini, E. D'Imporzano, S. DeNotariis, F. Bonometti, C. Paolillo, A. Riccardi, A. Tiozzo, M. DiBari, S. Vanni, A. Scarpa, D. Zara, P. Ranieri, M. Alessandro, F. Di, D. Pezzoni, C. Platto, V. D'Ambrosio, C. Ivaldi, P. Milia, F. DeSalvo, C. Solaro, M. Strazzacappa, M. Cazzadori, S. Confente, M. Grasso, E. Troisi, V. Guerini, B. Bernardini, C. Corsini, S. Boffelli, A. Filippi, K. Delpin, B. Faraci, E. Bertoletti, M. Vannucci, F. Tesi, P. Crippa, A. Malighetti, D. Bettini, F. Maltese, G. Abruzzese, D. Cosimo, M. Azzini, M. Colombo, G. Procino, S. Fascendini, F. Barocco, P. Del, A. Mazzone, E. Riva, D. Dell'Acqua, M. Cottino, G. Vezzadini, S. Avanzi, C. Brambilla, S. Orini, F. Sgrilli, A. Mello, L. Lombardi, E. Muti, B. Dijk, S. Fenu, C. Pes, P. Gareri, M. Passamonte, R. Rigo, L. Locusta, L. Caser, G. Rosso, S. Cesarini, R. Cozzi, C. Santini, P. Carbone, I. Cazzaniga, R. Lovati, A. Cantoni, P. Ranzani, D. Barra, G. Pompilio, S. Dimori, S. Cernesi, C. Riccò, F. Piazzolla, E. Capittini, C. Rota, F. Gottardi, L. Merla, A. Barelli, A. Millul, G. De, G. Morrone, M. Bigolari, M. Macchi, F. Zambon, C. Pizzorni, G. DiCasaleto, G. Menculini, M. Marcacci, G. Catanese, D. Sprini, T. DiCasalet, M. Bocci, S. Borga, P. Caironi, C. Cat, E. Cingolani, L. Avalli, G. Greco, G. Citerio, L. Gandini, G. Cornara, R. Lerda, L. Brazzi, F. Simeone, M. Caciorgna, D. Alampi, S. Francesconi, E. Beck, B. Antonini, K. Vettoretto, M. Meggiolaro, E. Garofalo, S. Notaro, R. Varutti, F. Bassi, G. Mistraletti, A. Marino, R. Rona, E. Rondelli, I. Riva, A. Scapigliati, A. Cortegiani, F. Vitale, L. Pistidda, R. D'Andrea, L. Querci, P. Gnesin, M. Todeschini, M. Lugano, G. Castelli, M. Ortolani, A. Cotoia, S. Maggiore, L. DiTizio, R. Graziani, I. Testa, E. Ferretti, C. Castioni, F. Lombardi, R. Caserta, M. Pasqua, S. Simoncini, F. Baccarini, M. Rispoli, F. Grossi, L. Cancelliere, M. Carnelli, F. Puccini, G. Biancofiore, A. Siniscalchi, C. Laici, E. Mossello, M. Torrini, G. Pasetti, S. Palmese, R. Oggioni, V. Mangani, S. Pini, M. Martelli, E. Rigo, F. Zuccalà, A. Cherri, R. Spina, I. Calamai, N. Petrucci, A. Caicedo, F. Ferri, P. Gritti, N. Brienza, R. Fonnesu, M. Dessena, G. Fullin, D. Saggioro, Morandi, A, Inzitari, M, Udina, C, Gual, N, Mota, M, Tassistro, E, Andreano, A, Cherubini, A, Gentile, S, Mossello, E, Marengoni, A, Olivé, A, Riba, F, Ruiz, D, de Jaime, E, Bellelli, G, Alessandro Morandi, Marco Inzitari, Cristina Udina, Neus Gual, Miriam Mota, Elena Tassistro, Anita Andreano, Antonio Cherubini, Simona Gentile, Enrico Mossello, Alessandra Marengoni, Anna Olivé, Francesc Riba, Domingo Ruiz, Elisabet de Jaime, Giuseppe Bellelli, Italian Study Group of Delirium, Claudio Borghi, Morandi, Alessandro, Inzitari, Marco, Udina, Cristina, Gual, Neu, Mota, Miriam, Tassistro, Elena, Andreano, Anita, Cherubini, Antonio, Gentile, Simona, Mossello, Enrico, Marengoni, Alessandra, Olivé, Anna, Riba, Francesc, Ruiz, Domingo, de Jaime, Elisabet, Bellelli, Giuseppe, and A Tarasconi, M Sella, S Auriemma, G Paternò, G Faggian, C Lucarelli, N De Grazia, C Alberto, A Margola, L Porcella, I Nardiello, E Chimenti, M Zeni, A Giani, S Famularo, E Romairone, C Minaglia, C Ceccotti, G Guerra, G Mantovani, F Monacelli, C Minaglia, T Candiani, A Ballestrero, C Minaglia, F Santolini, C Minaglia, M Rosso, V Bono, S Sibilla, P Dal Santo, M Ceci, P Barone, T Schirinzi, A Formenti, G Nastasi, G Isaia, D Gonella, A Battuello, S Casson, D Calvani, F Boni, A Ciaccio, R Rosa, G Sanna, S Manfredini, L Cortese, M Rizzo, R Prestano, A Greco, M Lauriola, G Gelosa, V Piras, M Arena, D Cosenza, A Bellomo, M LaMontagna, L Gabbani, L Lambertucci, S Perego, G Parati, G Basile, V Gallina, G Pilone, C Giudice, F De, L Pietrogrande, B De, M Mosca, I Corazzin, P Rossi, V Nunziata, F D'Amico, A Grippa, S Giardini, R Barucci, A Cossu, L Fiorin, M Arena, M Distefano, M Lunardelli, M Brunori, I Ruffini, E Abraham, A Varutti, E Fabbro, A Catalano, G Martino, D Leotta, A Marchet, G Dell'Aquila, A Scrimieri, M Davoli, M Casella, A Cartei, G Polidori, G Basile, D Brischetto, S Motta, R Saponara, P Perrone, G Russo, D Del, C Car, T Pirina, S Franzoni, A Cotroneo, F Ghiggia, G Volpi, C Menichetti, M Bo, A Panico, P Calogero, G Corvalli, M Mauri, E Lupia, R Manfredini, F Fabbian, A March, M Pedrotti, M Veronesi, E Strocchi, C Borghi, A Bianchetti, A Crucitti, V DiFrancesco, G Fontana, L Bonanni, F Barbone, C Serrati, G Ballardini, M Simoncelli, G Ceschia, C Scarpa, R Brugiolo, S Fusco, T Ciarambino, C Biagini, E Tonon, M Porta, D Venuti, M DelSette, M Poeta, G Barbagallo, G Trovato, A Delitala, P Arosio, F Reggiani, G Zuliani, B Ortolani, E Mussio, A Girardi, A Coin, G Ruotolo, A Castagna, M Masina, R Cimino, A Pinciaroli, G Tripodi, U Cannistrà, F Cassadonte, M Vatrano, L Scaglione, P Fogliacco, C Muzzuilini, F Romano, A Padovani, L Rozzini, A Cagnin, F Fragiacomo, G Desideri, E Liberatore, A Bruni, G Orsitto, M Franco, L Bonfrate, M Bonetto, N Pizio, G Magnani, G Cecchetti, A Longo, V Bubba, L Marinan, M Cotelli, M Turla, M Brunori, M Sessa, L Abruzzi, G Castoldi, D LoVetere, C Musacchio, M Novello, A Cavarape, A Bini, A Leonardi, F Seneci, W Grimaldi, F Seneci, F Fimognari, V Bambara, A Saitta, F Corica, M Braga, E Ettorre, C Camellini, G Bellelli, G Annoni, A Marengoni, A Bruni, A Crescenzo, G Noro, R Turco, M Ponzetto, L Giuseppe, B Mazzei, G Maiuri, D Costaggiu, R Damato, E Fabbro, M Formilan, G Patrizia, M Gallucci, C Minaglia, M Paragona, P Bini, D Modica, C Abati, M Clerici, I Barbera, F NigroImperiale, A Manni, C Votino, C Castiglioni, M Di, M Degl'Innocenti, G Moscatelli, S Guerini, C Casini, D Dini, E D'Imporzano, S DeNotariis, F Bonometti, C Paolillo, A Riccardi, A Tiozzo, A Riccardi, C Paolillo, M DiBari, S Vanni, A Scarpa, D Zara, P Ranieri, M Alessandro, P Calogero, G Corvalli, F Di, D Pezzoni, C Platto, V D'Ambrosio, C Ivaldi, P Milia, F DeSalvo, C Solaro, M Strazzacappa, M Bo, A Panico, M Cazzadori, S Confente, M Bonetto, M Grasso, E Troisi, G Magnani, G Cecchetti, V Guerini, B Bernardini, C Corsini, S Boffelli, A Filippi, K Delpin, B Faraci, E Bertoletti, M Vannucci, F Tesi, P Crippa, A Malighetti, D Bettini, F Maltese, M Formilan, G Abruzzese, C Minaglia, D Cosimo, M Azzini, M Cazzadori, M Colombo, G Procino, S Fascendini, F Barocco, P Del, F D'Amico, A Grippa, A Mazzone, E Riva, D Dell'Acqua, M Cottino, G Vezzadini, S Avanzi, C Brambilla, S Orini, F Sgrilli, A Mello, L Lombardi, E Muti, B Dijk, S Fenu, C Pes, P Gareri, A Castagna, M Passamonte, F De, R Rigo, L Locusta, L Caser, G Rosso, S Cesarini, R Cozzi, C Santini, P Carbone, I Cazzaniga, R Lovati, A Cantoni, P Ranzani, D Barra, G Pompilio, S Dimori, S Cernesi, C Riccò, F Piazzolla, E Capittini, C Rota, F Gottardi, L Merla, A Barelli, A Millul, G De, G Morrone, M Bigolari, C Minaglia, M Macchi, F Zambon, F D'Amico, F D'Amico, C Pizzorni, G DiCasaleto, G Menculini, M Marcacci, G Catanese, D Sprini, T DiCasalet, M Bocci, S Borga, P Caironi, C Cat, E Cingolani, L Avalli, G Greco, G Citerio, L Gandini, G Cornara, R Lerda, L Brazzi, F Simeone, M Caciorgna, D Alampi, S Francesconi, E Beck, B Antonini, K Vettoretto, M Meggiolaro, E Garofalo, A Bruni, S Notaro, R Varutti, F Bassi, G Mistraletti, A Marino, R Rona, E Rondelli, I Riva, A Scapigliati, A Cortegiani, F Vitale, L Pistidda, R D'Andrea, L Querci, P Gnesin, M Todeschini, M Lugano, G Castelli, M Ortolani, A Cotoia, S Maggiore, L DiTizio, R Graziani, I Testa, E Ferretti, C Castioni, F Lombardi, R Caserta, M Pasqua, S Simoncini, F Baccarini, M Rispoli, F Grossi, L Cancelliere, M Carnelli, F Puccini, G Biancofiore, A Siniscalchi, C Laici, E Mossello, M Torrini, G Pasetti, S Palmese, R Oggioni, V Mangani, S Pini, M Martelli, E Rigo, F Zuccalà, A Cherri, R Spina, I Calamai, N Petrucci, A Caicedo, F Ferri, P Gritti, N Brienza, R Fonnesu, M Dessena, G Fullin, D Saggioro

Subjects
medicine.medical_specialty, Activities of daily living, Cross-sectional study, Hearing loss, medicine.medical_treatment, Visual impairment, Psychological intervention, visual impairment, Socio-culturale, behavioral disciplines and activities, Hearing impairment, delirium, older, sensory deficits, visual impairment, sensory deficit, Hearing impairment, 03 medical and health sciences, delirium, older, sensory deficits, 0302 clinical medicine, Risk Factors, Activities of Daily Living, mental disorders, medicine, Humans, Dementia, 030212 general & internal medicine, LS4_4, Hearing Loss, General Nursing, Rehabilitation, business.industry, Health Policy, General Medicine, medicine.disease, nervous system diseases, Cross-Sectional Studies, Italy, Emergency medicine, Delirium, Geriatrics and Gerontology, medicine.symptom, business, 030217 neurology & neurosurgery
Abstract

Objective: Sensory deficits are important risk factors for delirium but have been investigated in single-center studies and single clinical settings. This multicenter study aims to evaluate the association between hearing and visual impairment or bi-sensory impairment (visual and hearing impairment) and delirium. Design: Cross-sectional study nested in the 2017 "Delirium Day" project. Setting and participants: Patients 65 years and older admitted to acute hospital medical wards, emergency departments, rehabilitation wards, nursing homes, and hospices in Italy. Methods: Delirium was assessed with the 4AT (a short tool for delirium assessment) and sensory deficits with a clinical evaluation. We assessed the association between delirium, hearing and visual impairment in multivariable logistic regression models, adjusting for: Model 1, we included predisposing factors for delirium (ie, dementia, weight loss and autonomy in the activities of daily living); Model 2, we added to Model 1 variables, which could be considered precipitating factors for delirium (ie, psychoactive drugs and urinary catheters). Results: A total of 3038 patients were included; delirium prevalence was 25%. Patients with delirium had a higher prevalence of hearing impairment (30.5% vs 18%; P < .001), visual impairment (24.2% vs 15.7%; P < .01) and bi-sensory impairment (16.2% vs 7.5%) compared with those without delirium. In the multivariable logistic regression analysis, the presence of bi-sensory impairment was associated with delirium in Model 1 [odds ratio (OR) 1.5, confidence interval (CI) 1.2-2.1; P = .00] and in Model 2 (OR 1.4; CI 1.1-1.9; P = .02), whereas the presence of visual and hearing impairment alone was not associated with delirium either in Model 1 (OR 0.8; CI 0.6-1.2, P = .36; OR 1.1; CI 0.8-1.4; P = .42) or in Model 2 (OR 0.8, CI 0.6-1.2, P = .27; OR 1.1, CI 0.8-1.4, P = .63). Conclusions and implications: Our findings support the importance of routine screening and specific interventions by a multidisciplinary team to implement optimal management of sensory impairments and hence prevention and the management of the patients with delirium.

Published
2021

10. Hemodynamic variations and pitfalls during venoarterial extracorporeal membrane oxygenation and left ventricular apical unloading as bridge to heart transplantation

Author

Charilaos Tsioulpas, F. Simeone, Matteo Cameli, Maria Concetta Pastore, Giulia Elena Mandoli, Massimo Maccherini, Serafina Valente, and Sonia Bernazzali

Subjects
medicine.medical_specialty, Left ventricular unloading, medicine.medical_treatment, Hemodynamics, Case Report, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Mechanical circulatory support, Internal medicine, Extracorporeal membrane oxygenation, medicine, 030212 general & internal medicine, Cardiogenic shock, Heart transplantation, business.industry, medicine.disease, medicine.anatomical_structure, surgical procedures, operative, Ventricle, Cardiology, Cardiology and Cardiovascular Medicine, business, Early referral
Abstract

Despite the exponential increase in venoarterial extracorporeal membrane oxygenation (VA-ECMO) use during the past decade, adult cardiac ECMO is still accompanied by a high mortality rate. Moreover, although left ventricular distension is now a well-known drawback of VA-ECMO, there seems to be great variability in the hemodynamic management strategies and in the results reported among the various centers. Hemodynamic management of VA-ECMO can be even more challenging when complex configurations are deployed. Here we present and discuss an interesting case of a modified VA-ECMO that although it occurred a few years ago it is instructive for its hemodynamic implications and pitfalls. VA-ECMO can either save the patient or catalyze the deterioration of a compromised clinical condition and thus a close multiparametric monitoring is mandatory especially with complex ECMO arrangements. A thorough understanding of the hemodynamic changes and problems that may occur during these cases is necessary too. Ultimately, critical thinking along with a proactive approach for early referral to more specialized centers and immediate unloading of the left ventricle whenever it is deemed necessary, together may contribute to reduce the relatively high mortality rate with this type of support. Learning objective: Venoarterial extracorporeal membrane oxygenation (VA-ECMO) can either save the patient or catalyze the deterioration of a compromised clinical condition if support-related drawbacks are not correctly identified and promptly adjusted. Management of complex VA-ECMO configurations can be challenging and thus a thorough understanding and close multiparametric monitoring of the hemodynamic implications and pitfalls are necessary in order to prevent negative outcomes.

Published
2021

11. CARACTERÍSTICAS QUÍMICAS E NUTRICIONAIS DE DOIS GENÓTIPOS DE SORGO, DEPOIS DA EXTRUSÃO TERMOPLÁSTICA

Author

Inayara Cristina Alves Lacerda, Monalisa Ribeiro Silva, M. L. F. Simeone, Gilberto Simeone Henriques, J. O. F. Melo, R. L. M. de Araújo, R. Augusti, A. L. C. C. Ramos, Valéria Aparecida Vieira Queiroz, and F. A. Campelo

Abstract

O objetivo deste trabalho foi avaliar o efeito da extrusao sobre a composicao nutricional, o teor de compostos fenolicos de dois genotipos de sorgo, ambos Sorgo bicolor, e caracterizar o perfil dos constituintes quimicos por espectrometria de massa por paper spray. Metodos: Foi avaliado o efeito do tratamento nos genotipos de sorgo SC 319 e BRS 332, realizando-se um delineamento inteiramente casualizado (DIC) com dois tratamentos (cru e extrusado) e tres repeticoes, analisando os fatores: cor, composicao centesimal, teor de compostos fenolicos, atividade antioxidante e perfil de constituintes quimicos. Resultados: A extrusao aumentou o conteudo de carboidratos e fibras e reduziu os valores de umidade, lipidios e cinzas, alem de permitir um maior grau de liberacao de compostos fenolicos e atividade antioxidante. A impressao digital obtida nos dois modos de ionizacao foi influenciada pela extrusao, permitindo uma maior identificacao dos compostos nas amostras extrusadas. A analise de componentes principais (ACP) permitiu distinguir os principais constituintes das amostras de sorgo, bem como destacar o efeito da extrusao e a influencia dos genotipos. Conclusao: O uso da extrusao termoplastica elevou teores de fibras, favorecendo a digestibilidade do amido, inclusive do genotipo contendo taninos (SC 319). O processo de extrusao aumentou a liberacao de compostos fenolicos totais. Os flavonoides das classes das flavonas, flavonois e acidos fenolicos, retratados no perfil de constituintes quimicos do sorgo extrusado permitem concluir que esse tratamento e capaz de melhorar a disponibilidade de compostos com caracteristicas bioativas, constituindo-se assim uma vantagem em relacao ao sorgo cru nao tratado.

Published
2021
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12. Case 36-2018: A 29-Year-Old Man with an Incidentally Discovered Renal Mass

Author

Joseph F. Simeone, Chin-Lee Wu, Philip J. Saylor, Douglas M. Dahl, and Othon Iliopoulos

Subjects
Adult, Male, medicine.medical_specialty, Varicocele, Kidney, urologic and male genital diseases, Translocation, Genetic, Diagnosis, Differential, Testis, medicine, Carcinoma, Renal mass, Humans, Spermatocele, Carcinoma, Renal Cell, Ultrasonography, Incidental Findings, Genitourinary system, business.industry, Kidney pathology, Testicular mass, General Medicine, Prognosis, medicine.disease, Kidney Neoplasms, Radiology, business
Abstract

A Man with an Incidentally Discovered Renal Mass A 29-year-old man was evaluated for a new, self-identified left testicular mass. Genitourinary ultrasonography revealed a varicocele on the left sid...

Published
2018
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14. Patient blood management in cardiac surgery: The 'Granducato algorithm'

Author

Daniele Marianello, Rita Paniccia, Paolo Del Sarto, Cornel Marusceac, Luca Marchetti, Michele Celiento, Claudia Cariello, Alberto Guadagnucci, Alessandra Pastorino, F. Simeone, Debora Castellani, Paolo Simioni, Sabino Scolletta, Valter Campagnolo, Marco Solinas, Cecilia Bianchi, Pietro Bertini, Paolo Fontanari, C. Bartolozzi, Fabio Guarracino, Dorela Haxhiademi, and Marco Ranucci

Subjects
Male, medicine.medical_specialty, Blood management, Blood transfusion, medicine.medical_treatment, Blood Loss, Surgical, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Surgical, medicine, Patient blood management, Humans, Blood Loss, Blood Transfusion, 030212 general & internal medicine, Cardiac Surgical Procedures, Bleeding, Cardiac surgery, Transfusion, Cardiology and Cardiovascular Medicine, Aged, Retrospective Studies, business.industry, Acute kidney injury, Retrospective cohort study, Female, Follow-Up Studies, Italy, Middle Aged, Algorithms, medicine.disease, Prothrombin complex concentrate, Confidence interval, Relative risk, business, Algorithm, medicine.drug
Abstract

Background Patients undergoing cardiac surgery are subject to severe alterations of the coagulation system. The four cardiac surgery centers in Tuscany (Italy) structured and shared an algorithm (Granducato Patient Blood Management algorithm, G-PBMa) with predefined interventions for patient blood management. The aim of the study is to analyze the impact of that algorithm on the transfusion needs and bleeding-related outcomes in a large patient population. Methods Multicenter retrospective observational study on 3839 patients undergoing cardiac surgery at the four cardiac centers in Tuscany. The G-PBMa was released at the end of 2015 and it was structured in three parts: pre-, intra-, and post-operative. The year 2014, before the G-PBMa (1955 patients) and the year 2016 (1884 patients) after the G-PBMa in place were compared. Logistic regression analyses were used. Results The main changes introduced were the routine application of viscoelastic tests in bleeding patients (+72%) and the use of fibrinogen and prothrombin complex concentrate (+67%). The G-PBMa resulted in a significant reduction in the overall transfusion rate and in the transfusion rate of the separate blood products (relative risk for transfusions: 0.75, 95% confidence interval 0.65–0.85, P = 0.001). For preoperative hemoglobin values of between 8 and 10 g/dL, the absolute difference in RBC transfusion rate before and after the G-PBMa introduction ranged around 15%–17%. The G-PBMa introduction determined lower ( P = 0.02) chest drain blood loss, lower ( P = 0.001) postoperative acute kidney injury and shorter ( P = 0.001) hospital stay. Conclusions The G-PBMa was effective in reducing blood loss, transfusion requirements, and resulted in a better outcome.

Published
2019

15. Fluid Management With a Simplified Conservative Protocol for the Acute Respiratory Distress Syndrome*

Author

G. Netzer, Joyce Lanier, N. Lavery, K. Liu, Carolyn S. Calfee, Daryl J. Kor, K. Hodgin, Rana Hejal, P. Lauto, M. Andrews, Dale M. Needham, L. Bezdijan, Timothy E Albertson, E. L. Warren, D. Schoenfeld, Brian M. Daniel, S. Bredow, Anita J. Reddy, Mark D. Eisner, K. Sundar, S. Brown, W. Beninati, C. Lawton, Russell R. Miller, K. Ludwig, S. Brierre, Daniel A. Culver, Christopher E. Cox, N. Bolouri, S. Jain, Venkata Bandi, C. Kardos, A. Harvey, Nancy Ringwood, D. Charbonnet, C. Romaine, D. Herr, Steven R Holets, P. Sloane, P. Lazar, Polly P. Bailey, David A. Schoenfeld, Mark Tidswell, S. Ouellette, J. McLean, Ellen L. Burnham, Kathleen D. Liu, Richard F. Hinds, A. Stowe, L. Kozikowski, Jay S. Steingrub, R. W. Ashton, J. J. Komara, G. Meyaski, Gordon R. Bernard, Herbert P. Wiedemann, Leonardo Seoane, T. Bost, Lisa M. Brown, E. Hirshberg, M. Waclawiw, T. Beck, Henry E. Fessler, T. Frederick, G. Simpson, D. Eckley, J. Byrne, Colin K. Grissom, J. Ferguson, C. Oldmixon, K. Bender, Joseph A. Govert, R. Tanaka, Burton W. Lee, J. Titus, Oscar Garcia, E. Vlastelin, C. Hebert, Michael A Gentile, John P. Hunt, Bennett P. deBoisblanc, K. Moreau, J. Thompson, Jorge A. Guzman, W. Hall, J. Germain, K. Overdier, C. Thomas, D. Hanselman, James F. Orme, D. Haney, L. Gray, Justin Dickerson, Alfred F. Connors, Daniel R. Brown, R. Morse, D. Ward, Catherine L. Hough, Anna Ungar, E. Hammond, N. Kumar, Eliotte L. Hirshberg, R. Wolken, Pedro A. Mendez-Tellez, Roy G. Brower, C. Bishop, Emir Festic, Rolf D. Hubmayr, H. Gallo, Kalpatha Guntupalli, K. Thompson, J. Blaauw, Summer Choudhury, Art Wheeler, C. Ross, Brian M. Morrissey, T. Hill, B. T. Thompson, J. Fearon, Nancy W. Knudsen, Lydia Chang, H. Highfield, E. Braden, C. Higgins, N. Shum, Peter Rock, Shannon S. Carson, H. Howes, L. DeSouza, Melissa A. Passe, J. Wright, Jonathon D. Truwit, Gail Weinmann, Marc Moss, C. LeBlanc, Stephanie J. Gundel, K. Kordesch, Susan Mogan, A. Workneh, Frank Thomas, Lindell K. Weaver, S. Groce, Timothy R. Watkins, D. Taylor, H. Zhou, T. Graydon, Terry P. Clemmer, M. Dubin, Jonathan E. Sevransky, A. Overton, C. Shanholtz, Mary Faith Marshall, Elizabeth Smoot, R. D. Hite, S. Barney, Todd W. Rice, S. Lasalvia, A. Antoine, M. Guha, K. Oakjones, R. Duncan Hite, C. Grissom, R. Miller, J. Maloney, S. Frankel, W. Alward, A. Austin, Leonard D. Hudson, Al Jephson, R. Tejedor, Samuel M. Brown, J. D. Thornton, Mary Ragusky, Neil R. MacIntyre, Augustine S. Lee, D. Murphy, L. Struck, Michael A. Matthay, Alan H. Morris, S. King, J. McKeehan, M. L. Warner, S. Rimkus, D. Kelley, Alan B. Marr, Richard Wilson, K. Van Gundy, Meredith Mealer, Michael W. Peterson, David N. Hager, C. Pope, Michael J. Lanspa, Ivor S. Douglas, P. Rock, M. Tidswell, M. Pearce, Andrea L. Harabin, Kathryn A. Sims, T. Jagneaux, F. Simeone, B. Jensen, Ognjen Gajic, P. Wright, Margaret A. Hays, Kyle B. Enfield, D. Nielsen, A. Morris, A. Sampaio, Margaret J. Neff, and Peter E. Morris

Subjects
Male, medicine.medical_specialty, Central Venous Pressure, Fluid management, Acute respiratory distress, Critical Care and Intensive Care Medicine, Random Allocation, Clinical Protocols, Treatment trial, Furosemide, medicine, Humans, Diuretics, Intensive care medicine, Retrospective Studies, Protocol (science), Respiratory Distress Syndrome, business.industry, Central venous pressure, Acute kidney injury, Shock, Retrospective cohort study, Middle Aged, Water-Electrolyte Balance, medicine.disease, Respiration, Artificial, United States, Intensive Care Units, Catheter, Fluid Therapy, Female, business
Abstract

In the Fluid and Catheter Treatment Trial (FACTT) of the National Institutes of Health Acute Respiratory Distress Syndrome Network, a conservative fluid protocol (FACTT Conservative) resulted in a lower cumulative fluid balance and better outcomes than a liberal fluid protocol (FACTT Liberal). Subsequent Acute Respiratory Distress Syndrome Network studies used a simplified conservative fluid protocol (FACTT Lite). The objective of this study was to compare the performance of FACTT Lite, FACTT Conservative, and FACTT Liberal protocols.Retrospective comparison of FACTT Lite, FACTT Conservative, and FACTT Liberal. Primary outcome was cumulative fluid balance over 7 days. Secondary outcomes were 60-day adjusted mortality and ventilator-free days through day 28. Safety outcomes were prevalence of acute kidney injury and new shock.ICUs of Acute Respiratory Distress Syndrome Network participating hospitals.Five hundred three subjects managed with FACTT Conservative, 497 subjects managed with FACTT Liberal, and 1,124 subjects managed with FACTT Lite.Fluid management by protocol.Cumulative fluid balance was 1,918 ± 323 mL in FACTT Lite, -136 ± 491 mL in FACTT Conservative, and 6,992 ± 502 mL in FACTT Liberal (p0.001). Mortality was not different between groups (24% in FACTT Lite, 25% in FACTT Conservative and Liberal, p = 0.84). Ventilator-free days in FACTT Lite (14.9 ± 0.3) were equivalent to FACTT Conservative (14.6 ± 0.5) (p = 0.61) and greater than in FACTT Liberal (12.1 ± 0.5, p0.001 vs Lite). Acute kidney injury prevalence was 58% in FACTT Lite and 57% in FACTT Conservative (p = 0.72). Prevalence of new shock in FACTT Lite (9%) was lower than in FACTT Conservative (13%) (p = 0.007 vs Lite) and similar to FACTT Liberal (11%) (p = 0.18 vs Lite).FACTT Lite had a greater cumulative fluid balance than FACTT Conservative but had equivalent clinical and safety outcomes. FACTT Lite is an alternative to FACTT Conservative for fluid management in Acute Respiratory Distress Syndrome.

Published
2015
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16. Tranexamic acid in coronary artery surgery: One-year results of the Aspirin and Tranexamic Acid for Coronary Artery Surgery (ATACAS) trial

Author

Paul S. Myles, Julian A. Smith, Jessica Kasza, Brendan Silbert, Mohandas Jayarajah, Thomas Painter, D. James Cooper, Silvana Marasco, John McNeil, Jean S. Bussières, Shay McGuinness, Kelly Byrne, Matthew T.V. Chan, Giovanni Landoni, Sophie Wallace, Andrew Forbes, Paul Myles, Julian Smith, Donald Esmore, Henry Krum, A. Tonkin, B. Buxton, S. Heritier, A. Merry, D. Liew, J. McNeil, A. Forbes, D.J. Cooper, S. Wallace, A. Meehan, P. Myles, W. Galagher, C. Farrington, A. Ditoro, L. Wutzlhofer, D. Story, P. Peyton, S. Baulch, S. Sidiropoulos, D. Potgieter, R.A. Baker, B. Pesudovs, E. O'Loughlin J Wells, P. Coutts, S. Bolsin, C. Osborne, K. Ives, J. Smith, A. Hulley, G. Christie-Taylor, T. Painter, S. Lang, H. Mackay, C. Cokis, S. March, P.G. Bannon, C. Wong, L. Turner, D. Scott, B. Silbert, S. Said, P. Corcoran, L. de Prinse, J.S. Bussières, N. Gagné, A. Lamy, L. Semelhago, M.T.V. Chan, M. Underwood, G.S.Y. Choi, B. Fung, G. Landoni, R. Lembo, F. Monaco, F. Simeone, D. Marianello, G. Alvaro, G. De Vuono, D. van Dijk, J. Dieleman, S. Numan, S. McGuinness, R. Parke, P. Raudkivi, E. Gilder, K. Byrne, J. Dunning, J. Termaat, G. Mans, M. Jayarajah, J. Alderton, D. Waugh, M.J. Platt, A. Pai, A. Sevillano, A. Lal, C. Sinclair, G. Kunst, A. Knighton, G.M. Cubas, P. Saravanan, R. Millner, V. Vasudevan, M. Patteril, E. Lopez, R. Basu, J. Lu, Myles, P, Smith, Ja, Kasza, J, Silbert, B, Jayarajah, M, Painter, T, Cooper, Dj, Marasco, S, Mcneil, J, Bussières, J, Mcguinness, S, Byrne, K, Chan, Mtv, Landoni, G, Wallace, S, Forbes, A, and ATACAS investigators and the ANZCA Clinical Trials, Network

Subjects
Male, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Time Factors, Antifibrinolytic, medicine.drug_class, Myocardial Infarction, disability-free survival, Hemorrhage, Coronary Artery Disease, anesthesia, 030204 cardiovascular system & hematology, antiplatelet, Coronary artery disease, Disability Evaluation, 03 medical and health sciences, 0302 clinical medicine, Double-Blind Method, Fibrinolytic Agents, Coronary thrombosis, Risk Factors, Activities of Daily Living, medicine, Humans, Myocardial infarction, Coronary Artery Bypass, antifibrinolytic, Stroke, Aged, Aspirin, business.industry, Coronary Thrombosis, Middle Aged, medicine.disease, Antifibrinolytic Agents, Progression-Free Survival, Cardiac surgery, Tranexamic Acid, 030228 respiratory system, major adverse cardiac event, Anesthesia, outcome, Female, Surgery, Cardiology and Cardiovascular Medicine, business, Tranexamic acid, medicine.drug
Abstract

Background Tranexamic acid reduces blood loss and transfusion requirements in cardiac surgery but may increase the risk of coronary graft thrombosis. We previously reported the 30-day results of a trial evaluating tranexamic acid for coronary artery surgery. Here we report the 1-year clinical outcomes. Methods Using a factorial design, we randomly assigned patients undergoing coronary artery surgery to receive aspirin or placebo and tranexamic acid or placebo. The results of the tranexamic acid comparison are reported here. The primary 1-year outcome was death or severe disability, the latter defined as living with a modified Katz activities of daily living score of less than 8. Secondary outcomes included a composite of myocardial infarction, stroke, and death from any cause through to 1 year after surgery. Results The rate of death or disability at 1 year was 3.8% in the tranexamic acid group and 4.4% in the placebo group (relative risk, 0.85; 95% confidence interval, 0.64-1.13; P = .27), and this did not significantly differ according to aspirin exposure at the time of surgery (interaction P = .073). The composite rate of myocardial infarction, stroke, and death up to 1 year after surgery was 14.3% in the tranexamic acid group and 16.4% in the placebo group (relative risk, 0.87; 95% CI, 0.76-1.00; P = .053). Conclusions In this trial of patients having coronary artery surgery, tranexamic acid did not affect death or severe disability through to 1 year after surgery. Further work should be done to explore possible beneficial effects on late cardiovascular events.

Published
2019
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17. RONC-20. VERTEBRAL BODY GROWTH RETARDATION FOLLOWING PROTON CRANIOSPINAL RADIATION

Author

Shannon M. MacDonald, Roshan V. Sethi, F. Simeone, Myrsini Ioakeim-Ioannidou, Andrzej Niemierko, Nancy J. Tarbell, Drosoula Giantsoudi, and Torunn I. Yock

Subjects
Vertebral body, Abstracts, Cancer Research, Oncology, Proton, Growth retardation, business.industry, Medicine, Neurology (clinical), Radiation, business, Nuclear medicine, Craniospinal
Abstract

BACKGROUND: Craniospinal irradiation (CSI) is standard treatment for several pediatric brain tumors, known to cause growth impairment for growing children. However limited publications exist quantifying the effect and none for proton therapy (PT). This work qualitatively and quantitatively analyzes the effect of proton CSI on growth impairment. METHODS: Retrospective analysis of 87 pediatric patients with CNS tumors treated with PT at the Massachusetts General Hospital between years 2002 and 2010. 55 patients received CSI while 32 patients, our control group, received cranial irradiation only. Vertebral body (VB) height was measured in midline at multiple levels of the spine (C3, C3-C4, T4, T4-T5, C3-T6, T4-T7, L3, L1-L5) on follow-up sagittal T1-weighted MRI scans. Our data was fitted using a mixed effects regression multivariable model, including follow-up time, CSI dose, age at CSI, hypothalamic dose and gender as parameters. RESULTS: With a median follow up of 69.6 months for patients treated with CSI and 52.9 months for our control group, a strong dependence of VB growth retardation on CSI dose, age at treatment and hypothalamic dose was found. Accounting for the difference in growth between genders, growth retardation was shown to be independent of gender. CONCLUSIONS: Although current practice of proton CSI allows for sparing of the anterior organs, the entire VB gets irradiated resulting in growth impairment of pediatric patients. Our work suggests a model quantitatively predicting the growth retardation of treated patients based on age at treatment, CSI dose and hypothalamic dose.

Published
2018
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18. Letter of intent for KM3NeT 2.0

Author

S Adrián-Martínez, M Ageron, F Aharonian, S Aiello, A Albert, F Ameli, E Anassontzis, M Andre, G Androulakis, M Anghinolfi, G Anton, M Ardid, T Avgitas, G Barbarino, E Barbarito, B Baret, J Barrios-Martí, B Belhorma, A Belias, E Berbee, A van den Berg, V Bertin, S Beurthey, V van Beveren, N Beverini, S Biagi, A Biagioni, M Billault, M Bondì, R Bormuth, B Bouhadef, G Bourlis, S Bourret, C Boutonnet, M Bouwhuis, C Bozza, R Bruijn, J Brunner, E Buis, J Busto, G Cacopardo, L Caillat, M Calamai, D Calvo, A Capone, L Caramete, S Cecchini, S Celli, C Champion, R Cherkaoui El Moursli, S Cherubini, T Chiarusi, M Circella, L Classen, R Cocimano, J A B Coelho, A Coleiro, S Colonges, R Coniglione, M Cordelli, A Cosquer, P Coyle, A Creusot, G Cuttone, A D’Amico, G De Bonis, G De Rosa, C De Sio, F Di Capua, I Di Palma, A F Díaz García, C Distefano, C Donzaud, D Dornic, Q Dorosti-Hasankiadeh, E Drakopoulou, D Drouhin, L Drury, M Durocher, T Eberl, S Eichie, D van Eijk, I El Bojaddaini, N El Khayati, D Elsaesser, A Enzenhöfer, F Fassi, P Favali, P Fermani, G Ferrara, C Filippidis, G Frascadore, L A Fusco, T Gal, S Galatà, F Garufi, P Gay, M Gebyehu, V Giordano, N Gizani, R Gracia, K Graf, T Grégoire, G Grella, R Habel, S Hallmann, H van Haren, S Harissopulos, T Heid, A Heijboer, E Heine, S Henry, J J Hernández-Rey, M Hevinga, J Hofestädt, C M F Hugon, G Illuminati, C W James, P Jansweijer, M Jongen, M de Jong, M Kadler, O Kalekin, A Kappes, U F Katz, P Keller, G Kieft, D Kießling, E N Koffeman, P Kooijman, A Kouchner, V Kulikovskiy, R Lahmann, P Lamare, A Leisos, E Leonora, M Lindsey Clark, A Liolios, C D Llorens Alvarez, D Lo Presti, H Löhner, A Lonardo, M Lotze, S Loucatos, E Maccioni, K Mannheim, A Margiotta, A Marinelli, O Mariş, C Markou, J A Martínez-Mora, A Martini, R Mele, K W Melis, T Michael, P Migliozzi, E Migneco, P Mijakowski, A Miraglia, C M Mollo, M Mongelli, M Morganti, A Moussa, P Musico, M Musumeci, S Navas, C A Nicolau, I Olcina, C Olivetto, A Orlando, A Papaikonomou, R Papaleo, G E Păvălaş, H Peek, C Pellegrino, C Perrina, M Pfutzner, P Piattelli, K Pikounis, G E Poma, V Popa, T Pradier, F Pratolongo, G Pühlhofer, S Pulvirenti, L Quinn, C Racca, F Raffaelli, N Randazzo, P Rapidis, P Razis, D Real, L Resvanis, J Reubelt, G Riccobene, C Rossi, A Rovelli, M Saldaña, I Salvadori, D F E Samtleben, A Sánchez García, A Sánchez Losa, M Sanguineti, A Santangelo, D Santonocito, P Sapienza, F Schimmel, J Schmelling, V Sciacca, M Sedita, T Seitz, I Sgura, F Simeone, I Siotis, V Sipala, B Spisso, M Spurio, G Stavropoulos, J Steijger, S M Stellacci, D Stransky, M Taiuti, Y Tayalati, D Tézier, S Theraube, L Thompson, P Timmer, C Tönnis, L Trasatti, A Trovato, A Tsirigotis, S Tzamarias, E Tzamariudaki, B Vallage, V Van Elewyck, J Vermeulen, P Vicini, S Viola, D Vivolo, M Volkert, G Voulgaris, L Wiggers, J Wilms, E de Wolf, K Zachariadou, J D Zornoza, J Zúñiga, Adrian-Martinez, S., Ageron, M., Aharonian, F., Aiello, S., Albert, A., Ameli, F., Anassontzis, E., Andre, M., Androulakis, G., Anghinolfi, M., Anton, G., Ardid, M., Avgitas, T., Barbarino, G., Barbarito, E., Baret, B., Barrios-Marti, J., Belhorma, B., Belias, A., Berbee, E., Van Den Berg, A., Bertin, V., Beurthey, S., Van Beveren, V., Beverini, N., Biagi, S., Biagioni, A., Billault, M., Bondi, M., Bormuth, R., Bouhadef, B., Bourlis, G., Bourret, S., Boutonnet, C., Bouwhuis, M., Bozza, C., Bruijn, R., Brunner, J., Buis, E., Busto, J., Cacopardo, G., Caillat, L., Calamai, M., Calvo, D., Capone, A., Caramete, L., Cecchini, S., Celli, S., Champion, C., El Moursli, R. C., Cherubini, S., Chiarusi, T., Circella, M., Classen, L., Cocimano, R., Coelho, J. A. B., Coleiro, A., Colonges, S., Coniglione, R., Cordelli, M., Cosquer, A., Coyle, P., Creusot, A., Cuttone, G., D'Amico, A., De Bonis, G., De Rosa, G., De Sio, C., Di Capua, F., Di Palma, I., Diaz Garcia, A. F., Distefano, C., Donzaud, C., Dornic, D., Dorosti-Hasankiadeh, Q., Drakopoulou, E., Drouhin, D., Drury, L., Durocher, M., Eberl, T., Eichie, S., Van Eijk, D., El Bojaddaini, I., El Khayati, N., Elsaesser, D., Enzenhofer, A., Fassi, F., Favali, P., Fermani, P., Ferrara, G., Filippidis, C., Frascadore, G., Fusco, L. A., Gal, T., Galata, S., Garufi, F., Gay, P., Gebyehu, M., Giordano, V., Gizani, N., Gracia, R., Graf, K., Gregoire, T., Grella, G., Habel, R., Hallmann, S., Van Haren, H., Harissopulos, S., Heid, T., Heijboer, A., Heine, E., Henry, S., Hernandez-Rey, J. J., Hevinga, M., Hofestadt, J., Hugon, C. M. F., Illuminati, G., James, C. W., Jansweijer, P., Jongen, M., De Jong, M., Kadler, M., Kalekin, O., Kappes, A., Katz, U. F., Keller, P., Kieft, G., Kiessling, D., Koffeman, E. N., Kooijman, P., Kouchner, A., Kulikovskiy, V., Lahmann, R., Lamare, P., Leisos, A., Leonora, E., Clark, M. L., Liolios, A., Alvarez, C. D. L., Lo Presti, D., Lohner, H., Lonardo, A., Lotze, M., Loucatos, S., Maccioni, E., Mannheim, K., Margiotta, A., Marinelli, A., Maris, O., Markou, C., Martinez-Mora, J. A., Martini, A., Mele, R., Melis, K. W., Michael, T., Migliozzi, P., Migneco, E., Mijakowski, P., Miraglia, A., Mollo, C. M., Mongelli, M., Morganti, M., Moussa, A., Musico, P., Musumeci, M., Navas, S., Nicolau, C. A., Olcina, I., Olivetto, C., Orlando, A., Papaikonomou, A., Papaleo, R., Pavalas, G. E., Peek, H., Pellegrino, C., Perrina, C., Pfutzner, M., Piattelli, P., Pikounis, K., Poma, G. E., Popa, V., Pradier, T., Pratolongo, F., Puhlhofer, G., Pulvirenti, S., Quinn, L., Racca, C., Raffaelli, F., Randazzo, N., Rapidis, P., Razis, P., Real, D., Resvanis, L., Reubelt, J., Riccobene, G., Rossi, C., Rovelli, A., Saldana, M., Salvadori, I., Samtleben, D. F. E., Garcia, A. S., Losa, A. S., Sanguineti, M., Santangelo, A., Santonocito, D., Sapienza, P., Schimmel, F., Schmelling, J., Sciacca, V., Sedita, M., Seitz, T., Sgura, I., Simeone, F., Siotis, I., Sipala, V., Spisso, B., Spurio, M., Stavropoulos, G., Steijger, J., Stellacci, S. M., Stransky, D., Taiuti, M., Tayalati, Y., Tezier, D., Theraube, S., Thompson, L., Timmer, P., Tonnis, C., Trasatti, L., Trovato, A., Tsirigotis, A., Tzamarias, S., Tzamariudaki, E., Vallage, B., Van Elewyck, V., Vermeulen, J., Vicini, P., Viola, S., Vivolo, D., Volkert, M., Voulgaris, G., Wiggers, L., Wilms, J., De Wolf, E., Zachariadou, K., Zornoza, J. D., Zuniga, J., Research unit Astroparticle Physics, Research unit Nuclear & Hadron Physics, Adrián-Martínez, S., Barrios-Martí, J., Bondì, M., El Moursli, R. Cherkaoui, Coelho, J.A.B., Díaz García, A.F., Enzenhöfer, A., Fusco, L.A., Galatà, S., Grégoire, T., Hernández-Rey, J.J., Hofestädt, J., Hugon, C.M.F., James, C.W., Katz, U.F., Kießling, D., Koffeman, E.N., Clark, M. Lindsey, Alvarez, C.D. Lloren, Löhner, H., Mariş, O., Martínez-Mora, J.A., Melis, K.W., Mollo, C.M., Nicolau, C.A., Pǎvǎlaş, G.E., Poma, G.E., Pühlhofer, G., Saldaña, M., Samtleben, D.F.E., García, A. Sánchez, Losa, A. Sánchez, Stellacci, S.M., Tézier, D., Tönnis, C., Zornoza, J.D., Zúñiga, J., Centre de Physique des Particules de Marseille (CPPM), Aix Marseille Université (AMU)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Centre National de la Recherche Scientifique (CNRS), Km3NeT Collaboration, Adrián Martínez, S., Barbarino, Giancarlo, Barrios Martí, J., DE ROSA, Gianfranca, DI CAPUA, Francesco, Díaz García, A. F., Dorosti Hasankiadeh, Q., Garufi, Fabio, Hernández Rey, J. J., Alvarez, C. D. Lloren, Martínez Mora, J. A., Mele, Rosa, Pǎvǎlaş, G. E., Vivolo, Daniele, Centre Tecnològic de Vilanova i la Geltrú, Universitat Politècnica de Catalunya. LAB - Laboratori d'Aplicacions Bioacústiques, Gravitation and Astroparticle Physics Amsterdam, Faculty of Science, Other Research IHEF (IoP, FNWI), IoP (FNWI), Adrian-Martinez, S, Ageron, M, Aharonian, F, Aiello, S, Albert, A, Ameli, F, Anassontzis, E, Andre, M, Androulakis, G, Anghinolfi, M, Anton, G, Ardid, M, Avgitas, T, Barbarino, G, Barbarito, E, Baret, B, Barrios-Marti, J, Belhorma, B, Belias, A, Berbee, E, van den Berg, A, Bertin, V, Beurthey, S, van Beveren, V, Beverini, N, Biagi, S, Biagioni, A, Billault, M, Bondi, M, Bormuth, R, Bouhadef, B, Bourlis, G, Bourret, S, Boutonnet, C, Bouwhuis, M, Bozza, C, Bruijn, R, Brunner, J, Buis, E, Busto, J, Cacopardo, G, Caillat, L, Calamai, M, Calvo, D, Capone, A, Caramete, L, Cecchini, S, Celli, S, Champion, C, El Moursli, Rc, Cherubini, S, Chiarusi, T, Circella, M, Classen, L, Cocimano, R, Coelho, Jab, Coleiro, A, Colonges, S, Coniglione, R, Cordelli, M, Cosquer, A, Coyle, P, Creusot, A, Cuttone, G, D'Amico, A, De Bonis, G, De Rosa, G, De Sio, C, Di Capua, F, Di Palma, I, Garcia, Afd, Distefano, C, Donzaud, C, Dornic, D, Dorosti-Hasankiadeh, Q, Drakopoulou, E, Drouhin, D, Drury, L, Durocher, M, Eberl, T, Eichie, S, van Eijk, D, El Bojaddaini, I, El Khayati, N, Elsaesser, D, Enzenhofer, A, Fassi, F, Favali, P, Fermani, P, Ferrara, G, Filippidis, C, Frascadore, G, Fusco, La, Gal, T, Galata, S, Garufi, F, Gay, P, Gebyehu, M, Giordano, V, Gizani, N, Gracia, R, Graf, K, Gregoire, T, Grella, G, Habel, R, Hallmann, S, van Haren, H, Harissopulos, S, Heid, T, Heijboer, A, Heine, E, Henry, S, Hernandez-Rey, Jj, Hevinga, M, Hofestadt, J, Hugon, Cmf, Illuminati, G, James, Cw, Jansweijer, P, Jongen, M, de Jong, M, Kadler, M, Kalekin, O, Kappes, A, Katz, Uf, Keller, P, Kieft, G, Kiessling, D, Koffeman, En, Kooijman, P, Kouchner, A, Kulikovskiy, V, Lahmann, R, Lamare, P, Leisos, A, Leonora, E, Clark, Ml, Liolios, A, Alvarez, Cdl, Lo Presti, D, Lohner, H, Lonardo, A, Lotze, M, Loucatos, S, Maccioni, E, Mannheim, K, Margiotta, A, Marinelli, A, Maris, O, Markou, C, Martinez-Mora, Ja, Martini, A, Mele, R, Melis, Kw, Michael, T, Migliozzi, P, Migneco, E, Mijakowski, P, Miraglia, A, Mollo, Cm, Mongelli, M, Morganti, M, Moussa, A, Musico, P, Musumeci, M, Navas, S, Nicolau, Ca, Olcina, I, Olivetto, C, Orlando, A, Papaikonomou, A, Papaleo, R, Pavalas, Ge, Peek, H, Pellegrino, C, Perrina, C, Pfutzner, M, Piattelli, P, Pikounis, K, Poma, Ge, Popa, V, Pradier, T, Pratolongo, F, Puhlhofer, G, Pulvirenti, S, Quinn, L, Racca, C, Raffaelli, F, Randazzo, N, Rapidis, P, Razis, P, Real, D, Resvanis, L, Reubelt, J, Riccobene, G, Rossi, C, Rovelli, A, Saldana, M, Salvadori, I, Samtleben, Dfe, Garcia, A, Losa, A, Sanguineti, M, Santangelo, A, Santonocito, D, Sapienza, P, Schimmel, F, Schmelling, J, Sciacca, V, Sedita, M, Seitz, T, Sgura, I, Simeone, F, Siotis, I, Sipala, V, Spisso, B, Spurio, M, Stavropoulos, G, Steijger, J, Stellacci, Sm, Stransky, D, Taiuti, M, Tayalati, Y, Tezier, D, Theraube, S, Thompson, L, Timmer, P, Tonnis, C, Trasatti, L, Trovato, A, Tsirigotis, A, Tzamarias, S, Tzamariudaki, E, Vallage, B, Van Elewyck, V, Vermeulen, J, Vicini, P, Viola, S, Vivolo, D, Volkert, M, Voulgaris, G, Wiggers, L, Wilms, J, de Wolf, E, Zachariadou, K, Zornoza, Jd, and Zuniga, J

Subjects
HIGH-ENERGY NEUTRINOS, Physics - Instrumentation and Detectors, Computer science, Deep sea neutrino telescope, Física::Física de partícules [Àrees temàtiques de la UPC], Field of view, Electron, 7. Clean energy, 01 natural sciences, String (physics), KM3NeT, ARCA, ORCA, neutrino astronomy, neutrino astrophysics, neutrino mass hierarchy, High Energy Physics - Experiment, Relativistic particle, High Energy Physics - Experiment (hep-ex), [PHYS.HEXP]Physics [physics]/High Energy Physics - Experiment [hep-ex], neutrino physics, deep sea neutrino telescope, High Energy Astrophysical Phenomena (astro-ph.HE), GAMMA-RAY BURSTS, OPT - Optics, TS - Technical Sciences, Industrial Innovation, [SDU.ASTR.HE]Sciences of the Universe [physics]/Astrophysics [astro-ph]/High Energy Astrophysical Phenomena [astro-ph.HE], Astrophysics::Instrumentation and Methods for Astrophysics, Instrumentation and Detectors (physics.ins-det), Naturwissenschaftliche Fakultät, 16. Peace & justice, COSMIC-RAYS, Neutrino mass hierarchy, Neutrino physics, Neutrino astronomy, Nano Technology, Neutrino, Nuclear and High Energy Physics, Astrophysics - Instrumentation and Methods for Astrophysics, Astrophysics - High Energy Astrophysical Phenomena, SUPER-KAMIOKANDE, MONTE-CARLO GENERATOR, Astrophysics::High Energy Astrophysical Phenomena, Hochenergie-Astrophysik Theorie - Abteilung Hofmann, FOS: Physical sciences, PARAMETRIC-RESONANCE, 0103 physical sciences, ddc:530, Neutrins, 14. Life underwater, [PHYS.PHYS.PHYS-INS-DET]Physics [physics]/Physics [physics]/Instrumentation and Detectors [physics.ins-det], 010306 general physics, Instrumentation and Methods for Astrophysics (astro-ph.IM), Cherenkov radiation, Block (data storage), 010308 nuclear & particles physics, SIGNAL (programming language), neutrino physic, Astronomy, Galactic plane, Neutrino astrophysics, [SDU.ASTR.IM]Sciences of the Universe [physics]/Astrophysics [astro-ph]/Instrumentation and Methods for Astrophysic [astro-ph.IM], FISICA APLICADA, ddc:520, ICECUBE DATA, ATMOSPHERIC NEUTRINOS, GALACTIC-CENTER
Abstract

The authors would like to thank D Allard, A Esmaili, G Fogli, O Mena, K Murase, S Palomares Ruiz, E Parizot, S T Petcov, S Razzaque, D Semikoz, A Yu Smirnov, F L Villante, F Vissani and R Zukanovich Funchal for their support and valuable discussions and suggestions in preparing this Letter of Intent., The main objectives of the KM3NeT Collaboration are (i) the discovery and subsequent observation of high-energy neutrino sources in the Universe and (ii) the determination of the mass hierarchy of neutrinos. These objectives are strongly motivated by two recent important discoveries, namely: (1) the highenergy astrophysical neutrino signal reported by IceCube and (2) the sizable contribution of electron neutrinos to the third neutrino mass eigenstate as reported by Daya Bay, Reno and others. To meet these objectives, the KM3NeT Collaboration plans to build a new Research Infrastructure consisting of a network of deep-sea neutrino telescopes in the Mediterranean Sea. A phased and distributed implementation is pursued which maximises the access to regional funds, the availability of human resources and the synergistic opportunities for the Earth and sea sciences community. Three suitable deep-sea sites are selected, namely off-shore Toulon (France), Capo Passero (Sicily, Italy) and Pylos (Peloponnese, Greece). The infrastructure will consist of three so-called building blocks. A building block comprises 115 strings, each string comprises 18 optical modules and each optical module comprises 31 photo-multiplier tubes. Each building block thus constitutes a threedimensional array of photo sensors that can be used to detect the Cherenkov light produced by relativistic particles emerging from neutrino interactions. Two building blocks will be sparsely configured to fully explore the IceCube signal with similar instrumented volume, different methodology, improved resolution and complementary field of view, including the galactic plane. One building block will be densely configured to precisely measure atmospheric neutrino oscillations., The authors acknowledge the financial support of the funding agencies: Centre National de la Recherche Scientifique (CNRS), Commission Européenne (FEDER fund and Marie Curie Program), Institut Universitaire de France (IUF), IdEx program and UnivEarthS Labex program at Sorbonne Paris Cité (ANR-10-LABX-0023 and ANR-11-IDEX-0005-02), France; The General Secretariat of Research and Technology (GSRT), Greece; Istituto Nazionale di Fisica Nucleare (INFN), Ministero dell'Istruzione, dell’Universitàe della Ricerca (MIUR), Italy; Agence de l’Oriental and CNRST, Morocco; Stichting voor Fundamenteel Onderzoek der Materie (FOM), Nederlandseorganisatie voor Wetenschappelijk Onderzoek (NWO), The Netherlands; National Authority for Scientific Research (ANCS), Romania; Plan Estatal de Investigación (refs. FPA2015-65150-C3-1-P, -2-P and -3-P, (MINECO/FEDER)), Severo Ochoa Centre of Excellence and MultiDark Consolider (MINECO), and Prometeo and Grisolía programs (Generalitat Valenciana), Spain. The KM3NeT collaboration has received funding from the European Community Sixth Framework Programme under Contract 011937 and the Seventh Framework Programme under Grant Agreement 212525.

Published
2016
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19. Long term monitoring of the optical background in the Capo Passero deep-sea site with the NEMO tower prototype

Author

Carmelo Pellegrino, F. Garufi, S. Pulvirenti, S. Aiello, M. Morganti, A. Spitaleri, Marco Circella, A. Enzenhöfer, Matteo Sanguineti, Giacomo Cuttone, Andrea Biagioni, Francesco Caruso, A. Gmerk, R. Masullo, Alberto Rovelli, A. Martini, Salvatore Viola, Annarita Margiotta, V. Giordano, C. D'Amato, Paolo Piattelli, M. Musumeci, L.A. Fusco, C. M. Mollo, E. Barbarito, S. Biagi, Irene Sgura, Giuseppina Larosa, D. Lattuada, M. Saldaña, Fabrizio Raffaelli, K. P. Leismüller, Mário Costa, Antonio Capone, S. Adrián-Martínez, D. Real, Giorgio Riccobene, Maurizio Spurio, F. Simeone, Alessandro Lonardo, F. Speziale, Antonio D'Amico, Nunzio Randazzo, Daniele Vivolo, M. Imbesi, C. Hugon, A. Trovato, C.A. Nicolau, D. Lo Presti, V. Sciacca, Cristiano Bozza, Nicolo' Beverini, P. Litrico, A. Miraglia, Emilio Migneco, Tommaso Chiarusi, F. C. T. Barbato, P. Migliozzi, N. Deniskina, G. De Rosa, V. Sipala, Carlo Ventura, G. De Bonis, Rosanna Cocimano, Riccardo Papaleo, Piera Sapienza, A. Orzelli, C. D. Llorens Alvarez, M. Anghinolfi, C. Pugliatti, A. Ceres, Simona Maria Stellacci, D. Calvo, V. Flaminio, Antonio Marinelli, F. Ameli, M. Mongelli, R. Coniglione, V. De Luca, F. Di Capua, Fabio Longhitano, Giovanna Ferrara, A. Orlando, Giancarlo Barbarino, B. Bouhadef, C. Distefano, M. Taiuti, Claudio Cali, V. Kulikovskiy, L. Trasatti, R. Lahmann, M. G. Pellegriti, Piero Vicini, G. Cacopardo, Miguel Ardid, Enrico Maccioni, Rosaria Grasso, E. Leonora, G. Terreni, P. Fermani, G. Grella, C. Perrina, P. Musico, M. Calamai, Adrián-Martínez, S., Aiello, S., Ameli, F., Anghinolfi, M., Ardid, M., Barbarino, G., Barbarito, E., Barbato, F.C.T., Beverini, N., Biagi, S., Biagioni, A., Bouhadef, B., Bozza, C., Cacopardo, G., Calamai, M., Calì, C., Calvo, D., Capone, A., Caruso, F., Ceres, A., Chiarusi, T., Circella, M., Cocimano, R., Coniglione, R., Costa, M., Cuttone, G., D’Amato, C., D’Amico, A., De Bonis, G., De Luca, V., Deniskina, N., De rosa, G., di Capua, F., Distefano, C., Enzenhöfer, A., Fermani, P., Ferrara, G., Flaminio, V., Fusco, L.A., Garufi, F., Giordano, V., Gmerk, A., Grasso, R., Grella, G., Hugon, C., Imbesi, M., Kulikovskiy, V., Lahmann, R., Larosa, G., Lattuada, D., Leismüller, K.P., Leonora, E., Litrico, P., Llorens alvarez, C.D., Lonardo, A., Longhitano, F., Lo presti, D., Maccioni, E., Margiotta, A., Marinelli, A., Martini, A., Masullo, R., Migliozzi, P., Migneco, E., Miraglia, A., Mollo, C.M., Mongelli, M., Morganti, M., Musico, P., Musumeci, M., Nicolau, C.A., Orlando, A., Orzelli, A., Papaleo, R., Pellegrino, C., Pellegriti, M.G., Perrina, C., Piattelli, P, Pugliatti, C., Pulvirenti, S., Raffaelli, F., Randazzo, N., Real, D., Riccobene, G., Rovelli, A., Saldaña, M., Sanguineti, M., Sapienza, P., Sciacca, V., Sgura, I., Simeone, F., Sipala, V., Speziale, F., Spitaleri, A., Spurio, M., Stellacci, S.M., Taiuti, M., Terreni, G., Trasatti, L., Trovato, A., Ventura, C., Vicini, P., Viola, S., Vivolo, D., Adrian-Martinez, S, Aiello, S, Ameli, F, Anghinolfi, M, Ardid, M, Barbarino, G, Barbarito, E, Barbato, Fct, Beverini, N, Biagi, S, Biagioni, A, Bouhadef, B, Bozza, C, Cacopardo, G, Calamai, M, Cali, C, Calvo, D, Capone, A, Caruso, F, Ceres, A, Chiarusi, T, Circella, M, Cocimano, R, Coniglione, R, Costa, M, Cuttone, G, D'Amato, C, D'Amico, A, De Bonis, G, De Luca, V, Deniskina, N, De Rosa, G, di Capua, F, Distefano, C, Enzenhofer, A, Fermani, P, Ferrara, G, Flaminio, V, Fusco, La, Garufi, F, Giordano, V, Gmerk, A, Grasso, R, Grella, G, Hugon, C, Imbesi, M, Kulikovskiy, V, Lahmann, R, Larosa, G, Lattuada, D, Leismuller, Kp, Leonora, E, Litrico, P, Alvarez, Cdl, Lonardo, A, Longhitano, F, Lo Presti, D, Maccioni, E, Margiotta, A, Marinelli, A, Martini, A, Masullo, R, Migliozzi, P, Migneco, E, Miraglia, A, Mollo, Cm, Mongelli, M, Morganti, M, Musico, P, Musumeci, M, Nicolau, Ca, Orlando, A, Orzelli, A, Papaleo, R, Pellegrino, C, Pellegriti, Mg, Perrina, C, Pugliatti, C, Pulvirenti, S, Raffaelli, F, Randazzo, N, Real, D, Riccobene, G, Rovelli, A, Saldana, M, Sanguineti, M, Sapienza, P, Sciacca, V, Sgura, I, Simeone, F, Sipala, V, Speziale, F, Spitaleri, A, Spurio, M, Stellacci, Sm, Taiuti, M, Terreni, G, Trasatti, L, Trovato, A, Ventura, C, Vicini, P, Viola, S, Vivolo, D, Adrián Martínez, S., Barbarino, Giancarlo, Barbato, FELICIA CARLA TIZIANA, DE ROSA, Gianfranca, DI CAPUA, Francesco, Fusco, L. A., Garufi, Fabio, Leismüller, K. P., Llorens alvarez, C. D., Migliozzi, Pasquale, Mollo, C. M., Nicolau, C. A., Pellegriti, M. G., Stellacci, S. M., Vivolo, Daniele, Adrian-Martinez, S., Barbato, F. C. T., Cali, C., D'Amato, C., D'Amico, A., Derosa, G., Enzenhofer, A., Leismuller, K. P., Llorensalvarez, C. D., Lopresti, D., Piattelli, P., Saldana, M., ARAG - AREA FINANZA E PARTECIPATE, DIPARTIMENTO DI FISICA E ASTRONOMIA 'AUGUSTO RIGHI', Da definire, and AREA MIN. 02 - Scienze fisiche

Subjects
optical properties, Physics - Instrumentation and Detectors, Design, Physics and Astronomy (miscellaneous), Instrumentation, Neutrino astronomy, KM3, FOS: Physical sciences, Project, Mediterranean, PHASE-2, KM3, 01 natural sciences, ACOUSTIC POSITIONING SYSTEM, NEUTRINO TELESCOPES, PROJECT, DESIGN, SMO, water Cherenkov, NEMO, Observatory, 0103 physical sciences, Underwater, Engineering (miscellaneous), 010306 general physics, Phase-2, Remote sensing, 010308 nuclear & particles physics, neutrino telescope, Capopassero, Instrumentation and Detectors (physics.ins-det), KM3NeT, Neutrino astronomy, FISICA APLICADA, Environmental science, Submarine pipeline, Light emission, Acoustic positioning system, Neutrino, Neutrino telescopes, Tower
Abstract

The NEMO Phase-2 tower is the first detector which was operated underwater for more than one year at the "record" depth of 3500 m. It was designed and built within the framework of the NEMO (NEutrino Mediterranean Observatory) project. The 380 m high tower was successfully installed in March 2013 80 km offshore Capo Passero (Italy). This is the first prototype operated on the site where the italian node of the KM3NeT neutrino telescope will be built. The installation and operation of the NEMO Phase-2 tower has proven the functionality of the infrastructure and the operability at 3500 m depth. A more than one year long monitoring of the deep water characteristics of the site has been also provided. In this paper the infrastructure and the tower structure and instrumentation are described. The results of long term optical background measurements are presented. The rates show stable and low baseline values, compatible with the contribution of 40K light emission, with a small percentage of light bursts due to bioluminescence. All these features confirm the stability and good optical properties of the site., Comment: 12 pages, 17 figures

Published
2016

20. The prototype detection unit of the KM3NeT detector: KM3NeT Collaboration

Author

S. Adrián-Martínez, M. Ageron, F. Aharonian, S. Aiello, A. Albert, F. Ameli, E. G. Anassontzis, G. C. Androulakis, M. Anghinolfi, G. Anton, S. Anvar, M. Ardid, T. Avgitas, K. Balasi, H. Band, G. Barbarino, E. Barbarito, F. Barbato, B. Baret, S. Baron, J. Barrios, A. Belias, E. Berbee, A. M. van den Berg, A. Berkien, V. Bertin, S. Beurthey, V. van Beveren, N. Beverini, S. Biagi, A. Biagioni, S. Bianucci, M. Billault, A. Birbas, H. Boer Rookhuizen, R. Bormuth, V. Bouché, B. Bouhadef, G. Bourlis, C. Boutonnet, M. Bouwhuis, C. Bozza, R. Bruijn, J. Brunner, G. Cacopardo, L. Caillat, M. Calamai, D. Calvo, A. Capone, L. Caramete, F. Caruso, S. Cecchini, A. Ceres, R. Cereseto, C. Champion, F. Château, T. Chiarusi, B. Christopoulou, M. Circella, L. Classen, R. Cocimano, A. Coleiro, S. Colonges, R. Coniglione, A. Cosquer, M. Costa, P. Coyle, A. Creusot, G. Cuttone, C. D’Amato, A. D’Amico, G. De Bonis, G. De Rosa, N. Deniskina, J.-J. Destelle, C. Distefano, F. Di Capua, C. Donzaud, D. Dornic, Q. Dorosti-Hasankiadeh, E. Drakopoulou, D. Drouhin, L. Drury, D. Durand, T. Eberl, D. Elsaesser, A. Enzenhöfer, P. Fermani, L. A. Fusco, D. Gajanana, T. Gal, S. Galatà, F. Garufi, M. Gebyehu, V. Giordano, N. Gizani, R. Gracia Ruiz, K. Graf, R. Grasso, G. Grella, A. Grmek, R. Habel, H. van Haren, T. Heid, A. Heijboer, E. Heine, S. Henry, J. J. Hernández-Rey, B. Herold, M. A. Hevinga, M. van der Hoek, J. Hofestädt, J. Hogenbirk, C. Hugon, J. Hößl, M. Imbesi, C. W. James, P. Jansweijer, J. Jochum, M. de Jong, M. Jongen, M. Kadler, O. Kalekin, A. Kappes, E. Kappos, U. Katz, O. Kavatsyuk, P. Keller, G. Kieft, E. Koffeman, H. Kok, P. Kooijman, J. Koopstra, A. Korporaal, A. Kouchner, I. Kreykenbohm, V. Kulikovskiy, R. Lahmann, P. Lamare, G. Larosa, D. Lattuada, H. Le Provost, K. P. Leismüller, A. Leisos, D. Lenis, E. Leonora, M. Lindsey Clark, C. D. Llorens Alvarez, H. Löhner, A. Lonardo, S. Loucatos, F. Louis, E. Maccioni, K. Mannheim, K. Manolopoulos, A. Margiotta, O. Mariş, C. Markou, J. A. Martínez-Mora, A. Martini, R. Masullo, K. W. Melis, T. Michael, P. Migliozzi, E. Migneco, A. Miraglia, C. M. Mollo, M. Mongelli, M. Morganti, S. Mos, Y. Moudden, P. Musico, M. Musumeci, C. Nicolaou, C. A. Nicolau, A. Orlando, A. Orzelli, A. Papaikonomou, R. Papaleo, G. E. Păvălaş, H. Peek, C. Pellegrino, M. G. Pellegriti, C. Perrina, P. Piattelli, K. Pikounis, V. Popa, Th. Pradier, M. Priede, G. Pühlhofer, S. Pulvirenti, C. Racca, F. Raffaelli, N. Randazzo, P. A. Rapidis, P. Razis, D. Real, L. Resvanis, J. Reubelt, G. Riccobene, A. Rovelli, M. Saldaña, D. F. E. Samtleben, M. Sanguineti, A. Santangelo, P. Sapienza, J. Schmelling, J. Schnabel, V. Sciacca, M. Sedita, T. Seitz, I. Sgura, F. Simeone, V. Sipala, A. Spitaleri, M. Spurio, G. Stavropoulos, J. Steijger, T. Stolarczyk, D. Stransky, M. Taiuti, G. Terreni, D. Tézier, S. Théraube, L. F. Thompson, P. Timmer, L. Trasatti, A. Trovato, M. Tselengidou, A. Tsirigotis, S. Tzamarias, E. Tzamariudaki, B. Vallage, V. Van Elewyck, J. Vermeulen, P. Vernin, P. Vicini, S. Viola, D. Vivolo, P. Werneke, L. Wiggers, J. Wilms, E. de Wolf, R. H. L. van Wooning, E. Zonca, J. D. Zornoza, J. Zúñiga, A. Zwart, Adrian-Martinez, S., Ageron, M., Aharonian, F., Aiello, S., Albert, A., Ameli, F., Anassontzis, E. G., Androulakis, G. C., Anghinolfi, M., Anton, G., Anvar, S., Ardid, M., Avgitas, T., Balasi, K., Band, H., Barbarino, G., Barbarito, E., Barbato, F., Baret, B., Baron, S., Barrios, J., Belias, A., Berbee, E., van den Berg, A. M., Berkien, A., Bertin, V., Beurthey, S., van Beveren, V., Beverini, N., Biagi, S., Biagioni, A., Bianucci, S., Billault, M., Birbas, A., Boer Rookhuizen, H., Bormuth, R., Bouche, V., Bouhadef, B., Bourlis, G., Boutonnet, C., Bouwhuis, M., Bozza, C., Bruijn, R., Brunner, J., Cacopardo, G., Caillat, L., Calamai, M., Calvo, D., Capone, A., Caramete, L., Caruso, F., Cecchini, S., Ceres, A., Cereseto, R., Champion, C., Chateau, F., Chiarusi, T., Christopoulou, B., Circella, M., Classen, L., Cocimano, R., Coleiro, A., Colonges, S., Coniglione, R., Cosquer, A., Costa, M., Coyle, P., Creusot, A., Cuttone, G., D'Amato, C., D'Amico, A., De Bonis, G., De Rosa, G., Deniskina, N., Destelle, J. -J., Distefano, C., Di Capua, F., Donzaud, C., Dornic, D., Dorosti-Hasankiadeh, Q., Drakopoulou, E., Drouhin, D., Drury, L., Durand, D., Eberl, T., Elsaesser, D., Enzenhofer, A., Fermani, P., Fusco, L. 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Subjects
Physics, Photomultiplier, Physics and Astronomy (miscellaneous), Physics::Instrumentation and Detectors, 010308 nuclear & particles physics, business.industry, Detector, Monte Carlo method, 01 natural sciences, Signal, Optics, KM3NeT, 0103 physical sciences, Calibration, 14. Life underwater, Neutrino, 010306 general physics, business, Engineering (miscellaneous), Cherenkov radiation
Abstract

A prototype detection unit of the KM3NeT deep-sea neutrino telescope has been installed at 3500m depth 80 km offshore the Italian coast. KM3NeT in its final configuration will contain several hundreds of detection units. Each detection unit is a mechanical structure anchored to the sea floor, held vertical by a submerged buoy and supporting optical modules for the detection of Cherenkov light emitted by charged secondary particles emerging from neutrino interactions. This prototype string implements three optical modules with 31 photomultiplier tubes each. These optical modules were developed by the KM3NeT Collaboration to enhance the detection capability of neutrino interactions. The prototype detection unit was operated since its deployment in May 2014 until its decommissioning in July 2015. Reconstruction of the particle trajectories from the data requires a nanosecond accuracy in the time calibration. A procedure for relative time calibration of the photomultiplier tubes contained in each optical module is described. This procedure is based on the measured coincidences produced in the sea by the $$^{40}$$40K background light and can easily be expanded to a detector with several thousands of optical modules. The time offsets between the different optical modules are obtained using LED nanobeacons mounted inside them. A set of data corresponding to 600 h of livetime was analysed. The results show good agreement with Monte Carlo simulations of the expected optical background and the signal from atmospheric muons. An almost background-free sample of muons was selected by filtering the time correlated signals on all the three optical modules. The zenith angle of the selected muons was reconstructed with a precision of about 3$$^circ $$∘.

Published
2016

21. Prevalence and features of delirium in older patients admitted to rehabilitation facilities

Author

Sidoli, Chiara, Zambon, Antonella, Tassistro, Elena, Rossi, Emanuela, Mossello, Enrico, Inzitari, Marco, Cherubini, Antonio, Marengoni, Alessandra, Morandi, Alessandro, Bellelli, Giuseppe, Tarasconi, A, Sella, M, Paternò, G, Faggian, G, Lucarelli, C, De Grazia, N, Alberto, C, Porcella, L, Nardiello, I, Chimenti, E, Zeni, M, Romairone, E, Minaglia, C, Ceccotti, C, Guerra, G, Mantovani, G, Monacelli, F, Candiani, T, Santolini, F, Rosso, M, Bono, V, Sibilla, S, Dal Santo, P, Ceci, M, Barone, P, Schirinzi, T, Formenti, A, Nastasi, G, Isaia, G, Gonella, D, Battuello, A, Casson, S, Calvani, D, Boni, F, Ciaccio, A, Rosa, R, Sanna, G, Manfredini, S, Cortese, L, Rizzo, M, Prestano, R, Greco, A, Lauriola, M, Gelosa, G, Piras, V, Arena, M, Cosenza, D, Bellomo, A, Lamontagna, M, Gabbani, L, Lambertucci, L, Perego, S, Parati, G, Basile, G, Gallina, V, Pilone, G, Giudice, C, Pietrogrande, L, Mosca, M, Corazzin, I, Rossi, P, Nunziata, V, D’Amico, F, Grippa, A, Giardini, S, Barucci, R, Cossu, A, Fiorin, L, Distefano, M, Lunardelli, M, Brunori, M, Ruffini, I, Abraham, E, Varutti, A, Fabbro, E, Catalano, A, Martino, G, Leotta, D, Marchet, A, Dell’Aquila, G, Scrimieri, A, Davoli, M, Casella, M, Cartei, A, Polidori, G, Brischetto, D, Motta, S, Saponara, R, Perrone, P, Russo, G, Del, D, Car, C, Pirina, T, Franzoni, S, Cotroneo, A, Ghiggia, F, Volpi, G, Menichetti, C, Bo, M, Panico, A, Calogero, P, Corvalli, G, Mauri, M, Lupia, E, Manfredini, R, Fabbian, F, March, A, Pedrotti, M, Veronesi, M, Strocchi, E, Borghi, C, Bianchetti, A, Crucitti, A, Difrancesco, V, Fontana, G, Geriatria, A, Bonanni, L, Barbone, F, Serrati, C, Ballardini, G, Simoncelli, M, Ceschia, G, Scarpa, C, Brugiolo, R, Fusco, S, Ciarambino, T, Biagini, C, Tonon, E, Porta, M, Venuti, D, Delsette, M, Poeta, M, Barbagallo, G, Trovato, G, Delitala, A, Arosio, P, Reggiani, F, Zuliani, G, Ortolani, B, Mussio, E, Girardi, A, Coin, A, Ruotolo, G, Castagna, A, Masina, M, Cimino, R, Pinciaroli, A, Tripodi, G, Cassadonte, F, Vatrano, M, Scaglione, L, Fogliacco, P, Muzzuilini, C, Romano, F, Padovani, A, Rozzini, L, Cagnin, A, Fragiacomo, F, Desideri, G, Liberatore, E, Bruni, A, Orsitto, G, Franco, M, Bonfrate, L, Bonetto, M, Pizio, N, Magnani, G, Cecchetti, G, Longo, A, Bubba, V, Marinan, L, Cotelli, M, Turla, M, Sessa, M, Abruzzi, L, Castoldi, G, Lovetere, D, Musacchio, C, Novello, M, Cavarape, A, Bini, A, Leonardi, A, Seneci, F, Grimaldi, W, Fimognari, F, Bambar, V, Saitta, A, Corica, F, Braga, M, Servi, Null, Ettorre, E, Camellini Bellelli, C G, Annoni, G, Marengoni, A, Crescenzo, A, Noro, G, Turco, R, Ponzetto, M, Giuseppe, L, Mazzei, B, Maiuri, G, Costaggiu, D, Damato, R, Formilan, M, Patrizia, G, Santuar, L, Gallucci, M, Paragona, M, Bini, P, Modica, D, Abati, C, Clerici, M, Barbera, I, Nigroimperiale, F, Manni, A, Votino, C, Castiglioni, C, Di, M, Degl’Innocenti, M, Moscatelli, G, Guerini, S, Casini, C, Dini, D, Denotariis, S, Bonometti, F, Paolillo, C, Riccardi, A, Tiozzo, A, Samysalamafahmy, A, Dibari, M, Vanni, S, Scarpa, A, Zara, D, Ranieri, P, Alessandro, M, Di, F, Pezzoni, D, Platto, C, D’Ambrosio, V, Ivaldi, C, Milia, P, Desalvo, F, Solaro, C, Strazzacappa, M, Cazzadori, M, Grasso, M, Troisi, E, Guerini, V, Bernardini, B, Corsini, C, Boffelli, S, Filippi, A, Delpin, K, Faraci, B, Bertoletti, E, Vannucci, M, Crippa, P, Malighetti, A, Caltagirone, C, Disant, S, Bettini, D, Maltese, F, Abruzzese, G, Cosimo, D, Azzini, M, Colombo, M, Procino, G, Fascendini, S, Barocco, F, Del, P, Mazzone, A, Cottino, M, Vezzadini, G, Avanzi, S, Brambilla, C, Orini, S, Sgrilli, F, Mello, A, Lombardi Muti, L E, Dijk, B, Fenu, S, Pes, C, Gareri, P, Passamonte, M, Rigo, R, Locusta, L, Caser, L, Rosso, G, Cesarini, S, Cozzi, R, Santini, C, Carbone, P, Cazzaniga, I, Lovati, R, Cantoni, A, Ranzani, P, Barra, D, Pompilio, G, Dimori, S, Cernesi, S, Riccò, C, Piazzolla, F, Capittini, E, Rota, C, Gottardi, F, Merla, L, Barelli, A, Millul, A, De, G, Morrone, G, Bigolari, M, Macchi, M, Zambon, F, Pizzorni, C, Dicasaleto, G, Menculini, G, Marcacci, M, Catanese, G, Sprini, D, Dicasalet, T, Bocci, M, Borga, S, Caironi, P, Cat, C, Cingolani, E, Avalli, L, Greco, G, Citerio, G, Gandini, L, Cornara, G, Lerda, R, Brazzi, L, Simeone, F, Caciorgna, M, Alampi, D, Francesconi, S, Beck, E, Antonini, B, Vettoretto, K, Meggiolaro, M, Garofalo, E, Notaro, S, Varutti, R, Bassi, F, Mistraletti, G, Marino, A, Rona, R, Rondelli, E, Riva, I, Cortegiani, A, Pistidda, L, D’Andrea, R, Querci, L, Gnesin, P, Todeschini, M, Lugano, M, Castelli, G, Ortolani, M, Cotoia, A, Maggiore, S, Ditizio, L, Graziani, R, Testa, I, Ferretti, E, Castioni, C, Lombardi, F, Caserta, R, Pasqua, M, Simoncini, S, Baccarini, F, Rispoli, M, Grossi, F, Cancelliere, L, Carnelli, M, Puccini, F, Biancofiore, G, Siniscalchi, A, Laici, C, Mossello, E, Torrini, M, Pasetti, G, Palmese, S, Oggioni, R, Mangani, V, Pini, S, Martelli, M, Rigo, E, Zuccalà, F, Cherri, A, Spina, R, Calamai, I, Petrucci, N, Caicedo, A, Ferri, F, Gritti, P, Brienza, N, Fonnesu, R, Dessena, M, Fullin, G, Saggioro, D, Sidoli, Chiara, Zambon, Antonella, Tassistro, Elena, Rossi, Emanuela, Mossello, Enrico, Inzitari, Marco, Cherubini, Antonio, Marengoni, Alessandra, Morandi, Alessandro, Bellelli, Giuseppe, A Tarasconi, M Sella, G Paternò, G Faggian, C Lucarelli, N De Grazia, C Alberto, L Porcella, I Nardiello, E Chimenti, M Zeni, E Romairone, C Minaglia, C Ceccotti, G Guerra, G Mantovani, F Monacelli, C Minaglia, T Candiani, F Santolini, C Minaglia, M Rosso, V Bono, S Sibilla, P Dal Santo, M Ceci, P Barone, T Schirinzi, A Formenti, G Nastasi, G Isaia, D Gonella, A Battuello, S Casson, D Calvani, F Boni, A Ciaccio, R Rosa, G Sanna, S Manfredini, L Cortese, M Rizzo, R Prestano, A Greco, M Lauriola, G Gelosa, V Piras, M Arena, D Cosenza, A Bellomo, M LaMontagna, L Gabbani, L Lambertucci, S Perego, G Parati, G Basile, V Gallina, G Pilone, C Giudice, L Pietrogrande, M Mosca, I Corazzin, P Rossi, V Nunziata, F D’Amico, A Grippa, S Giardini, R Barucci, A Cossu, L Fiorin, M Arena , M Distefano, M Lunardelli, M Brunori, I Ruffini, E Abraham, A Varutti, E Fabbro, A Catalano, G Martino, D Leotta, A Marchet, G Dell’Aquila, A Scrimieri, M Davoli, M Casella, A Cartei, G Polidori, G Basile, D Brischetto, S Motta, R Saponara, P Perrone, G Russo, D Del, C Car, T Pirina, S Franzoni, A Cotroneo, F Ghiggia, G Volpi, C Menichetti, M Bo, A Panico, P Calogero, G Corvalli, M Mauri, E Lupia, R Manfredini, F Fabbian, A March, M Pedrotti, M Veronesi, E Strocchi, C Borghi, A Bianchetti, A Crucitti, V DiFrancesco, G Fontana, A Geriatria, L Bonanni, F Barbone, C Serrati, G Ballardini, M Simoncelli, G Ceschia, C Scarpa, R Brugiolo, S Fusco, T Ciarambino, C Biagini, E Tonon, M Porta , D Venuti, M DelSette, M Poeta, G Barbagallo, G Trovato, A Delitala, P Arosio, F Reggiani, G Zuliani, B Ortolani, E Mussio, A Girardi, A Coin, G Ruotolo, A Castagna, M Masina, R Cimino, A Pinciaroli, G Tripodi, F Cassadonte, M Vatrano, L Scaglione, P Fogliacco, C Muzzuilini, F Romano, A Padovani, L Rozzini, A Cagnin, F Fragiacomo, G Desideri, E Liberatore, A Bruni, G Orsitto, M Franco, L Bonfrate, M Bonetto, N Pizio, G Magnani, G Cecchetti, A Longo, V Bubba, L Marinan, M Cotelli, M Turla, M Brunori, M Sessa, L Abruzzi, G Castoldi, D LoVetere, C Musacchio, M Novello, A Cavarape, A Bini, A Leonardi, F Seneci, W Grimaldi, F Seneci, F Fimognari, V Bambar, A Saitta, F Corica, M Braga, Servi, E Ettorre , C G Camellini Bellelli, G Annoni, A Marengoni, A Bruni, A Crescenzo, G Noro, R Turco, M Ponzetto, L Giuseppe, B Mazzei, G Maiuri, D Costaggiu, R Damato, E Fabbro, M Formilan, G Patrizia, L Santuar , M Gallucci, C Minaglia, M Paragona, P Bini, D Modica, C Abati, M Clerici, I Barbera, F NigroImperiale, A Manni, C Votino, C Castiglioni, M Di, M Degl’Innocenti, G Moscatelli, S Guerini, C Casini, D Dini, S DeNotariis, F Bonometti, C Paolillo, A Riccardi, A Tiozzo, A SamySalamaFahmy, A Riccardi, C Paolillo, M DiBari, S Vanni, A Scarpa, D Zara, P Ranieri, M Alessandro, P Calogero, G Corvalli, F Di, D Pezzoni, C Platto, V D’Ambrosio, C Ivaldi, P Milia, F DeSalvo, C Solaro, M Strazzacappa, M Bo, A Panico, M Cazzadori, M Bonetto, M Grasso, E Troisi, G Magnani, G Cecchetti, V Guerini, B Bernardini, C Corsini, S Boffelli, A Filippi, K Delpin, B Faraci, E Bertoletti, M Vannucci, P Crippa, A Malighetti, C Caltagirone, S DiSant, D Bettini, F Maltese, M Formilan, G Abruzzese, C Minaglia, D Cosimo, M Azzini, M Cazzadori, M Colombo, G Procino, S Fascendini, F Barocco, P Del, F D’Amico, A Grippa , A Mazzone, M Cottino, G Vezzadini, S Avanzi, C Brambilla, S Orini, F Sgrilli, A Mello, L E Lombardi Muti, B Dijk , S Fenu, C Pes, P Gareri, A Castagna, M Passamonte, R Rigo, L Locusta, L Caser, G Rosso, S Cesarini, R Cozzi, C Santini, P Carbone, I Cazzaniga, R Lovati, A Cantoni, P Ranzani, D Barra, G Pompilio, S Dimori, S Cernesi, C Riccò, F Piazzolla, E Capittini, C Rota, F Gottardi, L Merla, A Barelli, A Millul , G De, G Morrone, M Bigolari, C Minaglia, M Macchi, F Zambon, F D’Amico, F D’Amico, C Pizzorni, G DiCasaleto, G Menculini, M Marcacci, G Catanese, D Sprini, T DiCasalet, M Bocci, S Borga, P Caironi, C Cat, E Cingolani, L Avalli, G Greco, G Citerio, L Gandini, G Cornara, R Lerda, L Brazzi, F Simeone, M Caciorgna, D Alampi, S Francesconi, E Beck, B Antonini, K Vettoretto, M Meggiolaro, E Garofalo, A Bruni, S Notaro, R Varutti, F Bassi, G Mistraletti, A Marino, R Rona, E Rondelli, I Riva, A Cortegiani, L Pistidda, R D’Andrea, L Querci, P Gnesin, M Todeschini, M Lugano, G Castelli, M Ortolani, A Cotoia, S Maggiore, L DiTizio, R Graziani, I Testa, E Ferretti, C Castioni, F Lombardi, R Caserta, M Pasqua, S Simoncini, F Baccarini, M Rispoli, F Grossi, L Cancelliere, M Carnelli, F Puccini, G Biancofiore, A Siniscalchi, C Laici, E Mossello, M Torrini, G Pasetti, S Palmese, R Oggioni, V Mangani, S Pini, M Martelli, E Rigo, F Zuccalà , A Cherri, R Spina, I Calamai, N Petrucci, A Caicedo, F Ferri, P Gritti, N Brienza, R Fonnesu, M Dessena, G Fullin & D Saggioro, VU University medical center, Sidoli, C, Zambon, A, Tassistro, E, Rossi, E, Mossello, E, Inzitari, M, Cherubini, A, Marengoni, A, Morandi, A, Bellelli, G, Tarasconi, A, Sella, M, Paterno, G, Faggian, G, Lucarelli, C, De Grazia, N, Alberto, C, Porcella, L, Nardiello, I, Chimenti, E, Zeni, M, Romairone, E, Minaglia, C, Ceccotti, C, Guerra, G, Mantovani, G, Monacelli, F, Candiani, T, Santolini, F, Rosso, M, Bono, V, Sibilla, S, Dal Santo, P, Ceci, M, Barone, P, Schirinzi, T, Formenti, A, Nastasi, G, Isaia, G, Gonella, D, Battuello, A, Casson, S, Calvani, D, Boni, F, Ciaccio, A, Rosa, R, Sanna, G, Manfredini, S, Cortese, L, Rizzo, M, Prestano, R, Greco, A, Lauriola, M, Gelosa, G, Piras, V, Arena, M, Cosenza, D, Bellomo, A, Lamontagna, M, Gabbani, L, Lambertucci, L, Perego, S, Parati, G, Basile, G, Gallina, V, Pilone, G, Giudice, C, Pietrogrande, L, Mosca, M, Corazzin, I, Rossi, P, Nunziata, V, D'Amico, F, Grippa, A, Giardini, S, Barucci, R, Cossu, A, Fiorin, L, Distefano, M, Lunardelli, M, Brunori, M, Ruffini, I, Abraham, E, Varutti, A, Fabbro, E, Catalano, A, Martino, G, Leotta, D, Marchet, A, Dell'Aquila, G, Scrimieri, A, Davoli, M, Casella, M, Cartei, A, Polidori, G, Brischetto, D, Motta, S, Saponara, R, Perrone, P, Russo, G, Del, D, Car, C, Pirina, T, Franzoni, S, Cotroneo, A, Ghiggia, F, Volpi, G, Menichetti, C, Bo, M, Panico, A, Calogero, P, Corvalli, G, Mauri, M, Lupia, E, Manfredini, R, Fabbian, F, March, A, Pedrotti, M, Veronesi, M, Strocchi, E, Borghi, C, Bianchetti, A, Crucitti, A, Difrancesco, V, Fontana, G, Geriatria, A, Bonanni, L, Barbone, F, Serrati, C, Ballardini, G, Simoncelli, M, Ceschia, G, Scarpa, C, Brugiolo, R, Fusco, S, Ciarambino, T, Biagini, C, Tonon, E, Porta, M, Venuti, D, Delsette, M, Poeta, M, Barbagallo, G, Trovato, G, Delitala, A, Arosio, P, Reggiani, F, Zuliani, G, Ortolani, B, Mussio, E, Girardi, A, Coin, A, Ruotolo, G, Castagna, A, Masina, M, Cimino, R, Pinciaroli, A, Tripodi, G, Cassadonte, F, Vatrano, M, Scaglione, L, Fogliacco, P, Muzzuilini, C, Romano, F, Padovani, A, Rozzini, L, Cagnin, A, Fragiacomo, F, Desideri, G, Liberatore, E, Bruni, A, Orsitto, G, Franco, M, Bonfrate, L, Bonetto, M, Pizio, N, Magnani, G, Cecchetti, G, Longo, A, Bubba, V, Marinan, L, Cotelli, M, Turla, M, Sessa, M, Abruzzi, L, Castoldi, G, Lovetere, D, Musacchio, C, Novello, M, Cavarape, A, Bini, A, Leonardi, A, Seneci, F, Grimaldi, W, Fimognari, F, Bambar, V, Saitta, A, Corica, F, Braga, M, Servi, Ettorre, E, Camellini Bellelli, C, Annoni, G, Crescenzo, A, Noro, G, Turco, R, Ponzetto, M, Giuseppe, L, Mazzei, B, Maiuri, G, Costaggiu, D, Damato, R, Formilan, M, Patrizia, G, Santuar, L, Gallucci, M, Paragona, M, Bini, P, Modica, D, Abati, C, Clerici, M, Barbera, I, Nigroimperiale, F, Manni, A, Votino, C, Castiglioni, C, Di, M, Degl'Innocenti, M, Moscatelli, G, Guerini, S, Casini, C, Dini, D, Denotariis, S, Bonometti, F, Paolillo, C, Riccardi, A, Tiozzo, A, Samysalamafahmy, A, Dibari, M, Vanni, S, Scarpa, A, Zara, D, Ranieri, P, Alessandro, M, Di, F, Pezzoni, D, Platto, C, D'Ambrosio, V, Ivaldi, C, Milia, P, Desalvo, F, Solaro, C, Strazzacappa, M, Cazzadori, M, Grasso, M, Troisi, E, Guerini, V, Bernardini, B, Corsini, C, Boffelli, S, Filippi, A, Delpin, K, Faraci, B, Bertoletti, E, Vannucci, M, Crippa, P, Malighetti, A, Caltagirone, C, Disant, S, Bettini, D, Maltese, F, Abruzzese, G, Cosimo, D, Azzini, M, Colombo, M, Procino, G, Fascendini, S, Barocco, F, Del, P, Mazzone, A, Cottino, M, Vezzadini, G, Avanzi, S, Brambilla, C, Orini, S, Sgrilli, F, Mello, A, Lombardi Muti, L, Dijk, B, Fenu, S, Pes, C, Gareri, P, Passamonte, M, Rigo, R, Locusta, L, Caser, L, Rosso, G, Cesarini, S, Cozzi, R, Santini, C, Carbone, P, Cazzaniga, I, Lovati, R, Cantoni, A, Ranzani, P, Barra, D, Pompilio, G, Dimori, S, Cernesi, S, Ricco, C, Piazzolla, F, Capittini, E, Rota, C, Gottardi, F, Merla, L, Barelli, A, Millul, A, De, G, Morrone, G, Bigolari, M, Macchi, M, Zambon, F, Pizzorni, C, Dicasaleto, G, Menculini, G, Marcacci, M, Catanese, G, Sprini, D, Dicasalet, T, Bocci, M, Borga, S, Caironi, P, Cat, C, Cingolani, E, Avalli, L, Greco, G, Citerio, G, Gandini, L, Cornara, G, Lerda, R, Brazzi, L, Simeone, F, Caciorgna, M, Alampi, D, Francesconi, S, Beck, E, Antonini, B, Vettoretto, K, Meggiolaro, M, Garofalo, E, Notaro, S, Varutti, R, Bassi, F, Mistraletti, G, Marino, A, Rona, R, Rondelli, E, Riva, I, Cortegiani, A, Pistidda, L, D'Andrea, R, Querci, L, Gnesin, P, Todeschini, M, Lugano, M, Castelli, G, Ortolani, M, Cotoia, A, Maggiore, S, Ditizio, L, Graziani, R, Testa, I, Ferretti, E, Castioni, C, Lombardi, F, Caserta, R, Pasqua, M, Simoncini, S, Baccarini, F, Rispoli, M, Grossi, F, Cancelliere, L, Carnelli, M, Puccini, F, Biancofiore, G, Siniscalchi, A, Laici, C, Torrini, M, Pasetti, G, Palmese, S, Oggioni, R, Mangani, V, Pini, S, Martelli, M, Rigo, E, Zuccala, F, Cherri, A, Spina, R, Calamai, I, Petrucci, N, Caicedo, A, Ferri, F, Gritti, P, Brienza, N, Fonnesu, R, Dessena, M, Fullin, G, and Saggioro, D

Subjects
Aging, Disability, Rehabilitation, Delirium, Dementia, Physical restraint, Cross-Sectional Studies, Activities of Daily Living, mental disorders, Prevalence, Humans, Geriatrics and Gerontology, Aged
Abstract

Background: Delirium is thought to be common across various settings of care; however, still little research has been conducted in rehabilitation. Aim: We investigated the prevalence of delirium, its features and motor subtypes in older patients admitted to rehabilitation facilities during the three editions of the “Delirium Day project”. Methods: We conducted a cross-sectional study in which 1237 older patients (age ≥ 65 years old) admitted to 50 Italian rehabilitation wards during the three editions of the “Delirium Day project” (2015 to 2017) were included. Delirium was evaluated through the 4AT and its motor subtype with the Delirium Motor Subtype Scale. Results: Delirium was detected in 226 patients (18%), and the most recurrent motor subtype was mixed (37%), followed by hypoactive (26%), hyperactive (21%) and non-motor one (16%). In a multivariate Poisson regression model with robust variance, factors associated with delirium were: disability in basic (PR 1.48, 95%CI: 1.17–1.9, p value 0.001) and instrumental activities of daily living (PR 1.58, 95%CI: 1.08–2.32, p value 0.018), dementia (PR 2.10, 95%CI: 1.62–2.73, p value < 0.0001), typical antipsychotics (PR 1.47, 95%CI: 1.10–1.95, p value 0.008), antidepressants other than selective serotonin reuptake inhibitors (PR 1.3, 95%CI: 1.02–1.66, p value 0.035), and physical restraints (PR 2.37, 95%CI: 1.68–3.36, p value < 0.0001). Conclusion: This multicenter study reports that 2 out 10 patients admitted to rehabilitations had delirium on the index day. Mixed delirium was the most prevalent subtype. Delirium was associated with unmodifiable (dementia, disability) and modifiable (physical restraints, medications) factors. Identification of these factors should prompt specific interventions aimed to prevent or mitigate delirium.

Published
2022
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22. The association between low skeletal muscle mass and delirium: results from the nationwide multi-centre Italian Delirium Day 2017

Author

Zucchelli, A, Manzoni, F, Morandi, A, Di Santo, S, Rossi, E, Valsecchi, Mg, Inzitari, M, Cherubini, A, Bo, M, Mossello, E, Marengoni, A, Bellelli, G, Tarasconi, A, Sella, M, Auriemma, S, Paternò, G, Faggian, G, Lucarelli, C, De Grazia, N, Alberto, C, Margola, A, Porcella, L, Nardiello, I, Chimenti, E, Zeni, M, Giani, A, Famularo, S, Romairone, E, Minaglia, C, Ceccotti, C, Guerra, G, Mantovani, G, Monacelli, F, Candiani, T, Ballestrero, A, Santolini, F, Rosso, M, Bono, V, Sibilla, S, Dal Santo, P, Ceci, M, Barone, P, Schirinzi, T, Formenti, A, Nastasi, G, Isaia, G, Gonella, D, Battuello, A, Casson, S, Calvani, D, Boni, F, Ciaccio, A, Rosa, R, Sanna, G, Manfredini, S, Cortese, L, Rizzo, M, Prestano, R, Greco, A, Lauriola, M, Gelosa, G, Piras, V, Arena, M, Cosenza, D, Bellomo, A, Lamontagna, M, Gabbani, L, Lambertucci, L, Perego, S, Parati, G, Basile, G, Gallina, V, Pilone, G, Giudice, C, De, F, Pietrogrande, L, De, B, Mosca, M, Corazzin, I, Rossi, P, Nunziata, V, D'Amico, F, Grippa, A, Giardini, S, Barucci, R, Cossu, A, Fiorin, L, Distefano, M, Lunardelli, M, Brunori, M, Ruffini, I, Abraham, E, Varutti, A, Fabbro, E, Catalano, A, Martino, G, Leotta, D, Marchet, A, Dell'Aquila, G, Scrimieri, A, Davoli, M, Casella, M, Cartei, A, Polidori, G, Brischetto, D, Motta, S, Saponara, R, Perrone, P, Russo, G, Del, D, Car, C, Pirina, T, Franzoni, S, Cotroneo, A, Ghiggia, F, Volpi, G, Menichetti, C, Panico, A, Calogero, P, Corvalli, G, Mauri, M, Lupia, E, Manfredini, R, Fabbian, F, March, A, Pedrotti, M, Veronesi, M, Strocchi, E, Bianchetti, A, Crucitti, A, Di Francesco, V, Fontana, G, Bonanni, L, Barbone, F, Serrati, C, Ballardini, G, Simoncelli, M, Ceschia, G, Scarpa, C, Brugiolo, R, Fusco, S, Ciarambino, T, Biagini, C, Tonon, E, Porta, M, Venuti, D, Delsette, M, Poeta, M, Barbagallo, G, Trovato, G, Delitala, A, Arosio, P, Reggiani, F, Zuliani, G, Ortolani, B, Mussio, E, Girardi, A, Coin, A, Ruotolo, G, Castagna, A, Masina, M, Cimino, R, Pinciaroli, A, Tripodi, G, Cannistrà, U, Cassadonte, F, Vatrano, M, Scaglione, L, Fogliacco, P, Muzzuilini, C, Romano, F, Padovani, A, Rozzini, L, Cagnin, A, Fragiacomo, F, Desideri, G, Liberatore, E, Bruni, A, Orsitto, G, Franco, M, Bonfrate, L, Bonetto, M, Pizio, N, Magnani, G, Cecchetti, G, Longo, A, Bubba, V, Marinan, L, Cotelli, M, Turla, M, Sessa, M, Abruzzi, L, Castoldi, G, Lovetere, D, Musacchio, C, Novello, M, Cavarape, A, Bini, A, Leonardi, A, Seneci, F, Grimaldi, W, Fimognari, F, Bambara, V, Saitta, A, Corica, F, Braga, M, Ettorre, E, Camellini, C, Crescenzo, A, Noro, G, Turco, R, Ponzetto, M, Giuseppe, L, Mazzei, B, Maiuri, G, Costaggiu, D, Damato, R, Formilan, M, Patrizia, G, Santuari, L, Gallucci, M, Paragona, M, Bini, P, Modica, D, Abati, C, Clerici, M, Barbera, I, Nigroimperiale, F, Manni, A, Votino, C, Castiglioni, C, Di, M, Degl'Innocenti, M, Moscatelli, G, Guerini, S, Casini, C, Dini, D, D'Imporzano, E, Denotariis, S, Bonometti, F, Paolillo, C, Riccardi, A, Tiozzo, A, Samy Salama Fahmy, A, Dibari, M, Vanni, S, Scarpa, A, Zara, D, Ranieri, P, Pezzoni, D, Gentile, S, Platto, C, D'Ambrosio, V, Faraci, B, Brambilla, C, Ivaldi, C, Milia, P, Desalvo, F, Solaro, C, Strazzacappa, M, Cazzadori, M, Confente, S, Grasso, M, Troisi, E, Guerini, V, Bernardini, B, C Boffelli S, Corsini, Filippi, A, Delpin, K, Bertoletti, E, Vannucci, M, Tesi, F, Crippa, P, Malighetti, A, Caltagirone, C, Disant, S, Bettini, D, Maltese, F, Abruzzese, G, Cosimo, D, Azzini, M, Colombo, M, Procino, G, Fascendini, S, Barocco, F, Del, P, Mazzone, A, Riva, E, Dell'Acqua, D, Cottino, M, Vezzadini, G, Avanzi, S, Orini, S, Sgrilli, F, Mello, A, Lombardi, L, Muti, E, Dijk, B, Fenu, S, Pes, C, Gareri, P, Passamonte, M, Rigo, R, Locusta, L, Caser, L, Rosso, G, Cesarini, S, Cozzi, R, Santini, C, Carbone, P, Cazzaniga, I, Lovati, R, Cantoni, A, Ranzani, P, Barra, D, Pompilio, G, Dimori, S, Cernesi, S, Riccò, C, Piazzolla, F, Capittini, E, Rota, C, Gottardi, F, Merla, L, A Millul A, Barelli, De, G, Morrone, G, Bigolari, M, Macchi, M, Zambon, F, Pizzorni, C, Dicasaleto, G, Menculini, G, Marcacci, M, Catanese, G, Sprini, D, Dicasalet, T, Bocci, M, Borga, S, Caironi, P, Cat, C, Cingolani, E, Avalli, L, Greco, G, Citerio, G, Gandini, L, Cornara, G, Lerda, R, Brazzi, L, Simeone, F, Caciorgna, M, Alampi, D, Francesconi, S, Beck, E, Antonini, B, Vettoretto, K, Meggiolaro, M, Garofalo, E, Notaro, S, Varutti, R, Bassi, F, Mistraletti, G, Marino, A, Rona, R, Rondelli, E, Riva, I, Scapigliati, A, Cortegiani, A, Vitale, F, Pistidda, L, D'Andrea, R, Querci, L, Gnesin, P, Todeschini, M, Lugano, M, Castelli, G, Ortolani, M, Cotoia, A, Maggiore, S, Ditizio, L, Graziani, R, Testa, I, Ferretti, E, Castioni, C, Lombardi, F, Caserta, R, Pasqua, M, Simoncini, S, Baccarini, F, Rispoli, M, Grossi, F, Cancelliere, L, Carnelli, M, Puccini, F, Biancofiore, G, Siniscalchi, A, Laici, C, Torrini, M, Pasetti, G, Palmese, S, Oggioni, R, Mangani, V, Pini, S, Martelli, M, Rigo, E, Zuccalà, F, Cherri, A, Spina, R, Calamai, I, Petrucci, N, Caicedo, A, Ferri, F, Gritti, P, Brienza, N, Fonnesu, R, Dessena, M, Fullin, G, Saggioro, D., Zucchelli, A, Manzoni, F, Morandi, A, Di Santo, S, Rossi, E, Valsecchi, M, Inzitari, M, Cherubini, A, Bo, M, Mossello, E, Marengoni, A, Bellelli, G, Citerio, G, Zucchelli, Alberto, Valsecchi, M G, and A Tarasconi, M Sella, S Auriemma, G Paternò, G Faggian, C Lucarelli, N De Grazia, C Alberto, A Margola, L Porcella, I Nardiello, E Chimenti, M Zeni, A Giani, S Famularo, E Romairone, C Minaglia, C Ceccotti, G Guerra, G Mantovani, F Monacelli, C Minaglia, T Candiani, A Ballestrero, C Minaglia, F Santolini, C Minaglia, M Rosso, V Bono, S Sibilla, P Dal Santo, M Ceci, P Barone, T Schirinzi, A Formenti, G Nastasi, G Isaia, D Gonella, A Battuello, S Casson, D Calvani, F Boni, A Ciaccio, R Rosa, G Sanna, S Manfredini, L Cortese, M Rizzo, R Prestano, A Greco, M Lauriola, G Gelosa, V Piras, M Arena, D Cosenza, A Bellomo, M LaMontagna, L Gabbani, L Lambertucci, S Perego, G Parati, G Basile, V Gallina, G Pilone, C Giudice, F De, L Pietrogrande, B De, M Mosca, I Corazzin, P Rossi, V Nunziata, F D'Amico, A Grippa, S Giardini, R Barucci, A Cossu, L Fiorin, M Arena, M Distefano, M Lunardelli, M Brunori, I Ruffini, E Abraham, A Varutti, E Fabbro, A Catalano, G Martino, D Leotta, A Marchet, G Dell'Aquila, A Scrimieri, M Davoli, M Casella, A Cartei, G Polidori, G Basile, D Brischetto, S Motta, R Saponara, P Perrone, G Russo, D Del, C Car, T Pirina, S Franzoni, A Cotroneo, F Ghiggia, G Volpi, C Menichetti, M Bo, A Panico, P Calogero, G Corvalli, M Mauri, E Lupia, R Manfredini, F Fabbian, A March, M Pedrotti, M Veronesi, E Strocchi, A Bianchetti, A Crucitti, V Di Francesco, G Fontana, L Bonanni, F Barbone, C Serrati, G Ballardini, M Simoncelli, G Ceschia, C Scarpa, R Brugiolo, S Fusco, T Ciarambino, C Biagini, E Tonon, M Porta, D Venuti, M DelSette, M Poeta, G Barbagallo, G Trovato, A Delitala, P Arosio, F Reggiani, G Zuliani, B Ortolani, E Mussio, A Girardi, A Coin, G Ruotolo, A Castagna, M Masina, R Cimino, A Pinciaroli, G Tripodi, U Cannistrà, F Cassadonte, M Vatrano, F Cassandonte, L Scaglione, P Fogliacco, C Muzzuilini, F Romano, A Padovani, L Rozzini, A Cagnin, F Fragiacomo, G Desideri, E Liberatore, A Bruni, G Orsitto, M Franco, L Bonfrate, M Bonetto, N Pizio, G Magnani, G Cecchetti, A Longo, V Bubba, L Marinan, M Cotelli, M Turla, M Brunori, M Sessa, L Abruzzi, G Castoldi, D LoVetere, C Musacchio, M Novello, A Cavarape, A Bini, A Leonardi, F Seneci, W Grimaldi, F Fimognari, V Bambara, A Saitta, F Corica, M Braga, E Ettorre, C Camellini, A Marengoni, A Bruni, A Crescenzo, G Noro, R Turco, M Ponzetto, L Giuseppe, B Mazzei, G Maiuri, D Costaggiu, R Damato, E Fabbro, G Patrizia, L Santuari, M Gallucci, C Minaglia, M Paragona, P Bini, D Modica, C Abati, M Clerici, I Barbera, F NigroImperiale, A Manni, C Votino, C Castiglioni, M Di, M Degl'Innocenti, G Moscatelli, S Guerini, C Casini, D Dini, S DeNotariis, F Bonometti, C Paolillo, A Riccardi, A Tiozzo, A SamySalamaFahmy, A Riccardi, C Paolillo, M DiBari, S Vanni, A Scarpa, D Zara, P Ranieri, P Calogero, G Corvalli, D Pezzoni, S Gentile, A Morandi, C Platto, V D'Ambrosio, B Faraci, C Ivaldi, P Milia, F DeSalvo, C Solaro, M Strazzacappa, M Bo, A Panico, M Cazzadori, S Confente, M Bonetto, G Magnani, G Cecchetti, V Guerini, B Bernardini, C Corsini, S Boffelli, A Filippi, K Delpin, E Bertoletti, M Vannucci, F Tesi, P Crippa, A Malighetti, C Caltagirone, S DiSant, D Bettini, F Maltese, M Formilan, G Abruzzese, C Minaglia, D Cosimo, M Azzini, M Cazzadori, M Colombo, G Procino, S Fascendini, F Barocco, P Del, F D'Amico, A Grippa, A Mazzone, E Riva, D Dell'Acqua, M Cottino, G Vezzadini, S Avanzi, S Orini, F Sgrilli, A Mello, L Lombardi, E Muti, B Dijk, S Fenu, C Pes, P Gareri, A Castagna, M Passamonte, F De, R Rigo, L Locusta, L Caser, G Rosso, S Cesarini, R Cozzi, C Santini, P Carbone, I Cazzaniga, R Lovati, A Cantoni, P Ranzani, D Barra, G Pompilio, S Dimori, S Cernesi, C Riccò, F Piazzolla, E Capittini, C Rota, F Gottardi, L Merla, A Barelli, A Millul, G De, G Morrone, M Bigolari, C Minaglia, M Macchi, F Zambon, F D'Amico, F D'Amico, C Pizzorni, G DiCasaleto, G Menculini, M Marcacci, G Catanese, D Sprini, T DiCasalet, M Bocci, S Borga, P Caironi, C Cat, E Cingolani, L Avalli, G Greco, G Citerio, L Gandini, G Cornara, R Lerda, L Brazzi, F Simeone, M Caciorgna, D Alampi, S Francesconi, E Beck, B Antonini, K Vettoretto, M Meggiolaro, E Garofalo, A Bruni, S Notaro, R Varutti, F Bassi, G Mistraletti, A Marino, R Rona, E Rondelli, I Riva, A Scapigliati, A Cortegiani, F Vitale, L Pistidda, R D'Andrea, L Querci, P Gnesin, M Todeschini, M Lugano, G Castelli, M Ortolani, A Cotoia, S Maggiore, L DiTizio, R Graziani, I Testa, E Ferretti, C Castioni, F Lombardi, R Caserta, M Pasqua, S Simoncini, F Baccarini, M Rispoli, F Grossi, L Cancelliere, M Carnelli, F Puccini, G Biancofiore, A Siniscalchi, C Laici, E Mossello, M Torrini, G Pasetti, S Palmese, R Oggioni, V Mangani, S Pini, M Martelli, E Rigo, F Zuccalà, A Cherri, R Spina, I Calamai, N Petrucci, A Caicedo, F Ferri, P Gritti, N Brienza, R Fonnesu, M Dessena, G Fullin, D Saggioro

Subjects
Male, Aging, medicine.medical_specialty, Sarcopenia, medicine.medical_treatment, Socio-culturale, Older person, Logistic regression, Delirium, Older persons, Sarcopenia, Internal medicine, mental disorders, Delirium, Older persons, medicine, Dementia, Humans, LS4_4, Muscle, Skeletal, Pathological, Aged, Rehabilitation, business.industry, Area under the curve, Settore MED/23 - Chirurgia Cardiaca, Skeletal, medicine.disease, Skeletal muscle mass, Cross-Sectional Studies, Italy, Muscle, Female, Geriatrics and Gerontology, medicine.symptom, business
Abstract

Introduction Delirium and sarcopenia are common, although underdiagnosed, geriatric syndromes. Several pathological mechanisms can link delirium and low skeletal muscle mass, but few studies have investigated their association. We aimed to investigate (1) the association between delirium and low skeletal muscle mass and (2) the possible role of calf circumference mass in finding cases with delirium. Methods The analyses were conducted employing the cross-sectional “Delirium Day” initiative, on patient 65 years and older admitted to acute hospital medical wards, emergency departments, rehabilitation wards, nursing homes and hospices in Italy in 2017. Delirium was diagnosed as a 4 + score at the 4-AT scale. Low skeletal muscle mass was operationally defined as calf circumference ≤ 34 cm in males and ≤ 33 cm in females. Logistic regression models were used to investigate the association between low skeletal muscle mass and delirium. The discriminative ability of calf circumference was evaluated using non-parametric ROC analyses. Results A sample of 1675 patients was analyzed. In total, 73.6% of participants had low skeletal muscle mass and 24.1% exhibited delirium. Low skeletal muscle mass and delirium showed an independent association (OR: 1.50; 95% CI 1.09–2.08). In the subsample of patients without a diagnosis of dementia, the inclusion of calf circumference in a model based on age and sex significantly improved its discriminative accuracy [area under the curve (AUC) 0.69 vs 0.57, p Discussion and conclusion Low muscle mass is independently associated with delirium. In patients without a previous diagnosis of dementia, calf circumference may help to better identify those who develop delirium.

Published
2022

23. Nomogram for predicting the likelihood of postoperative surgical complications in patients treated with partial nephrectomy: a prospective multicentre observational study (the RECORd 2 project)

Author

Mari, A., Campi, R., Schiavina, R., Amparore, D., Antonelli, A., Artibani, W., Barale, M., Bertini, R., Borghesi, M., Bove, P., Brunocilla, E., Capitanio, U., Da Pozzo, L., Daja, J., Gontero, P., Larcher, A., Li Marzi, V., Longo, N., Mirone, V., Montanari, E., Pisano, F., Porpiglia, F., Simeone, C., Siracusano, S., Tellini, R., Trombetta, C., Volpe, A., Ficarra, V., Carini, M., Minervini, A., Altieri, V., Berardinelli, F., Celia, A., Costantini, E., Di Maida, F., Falsaperla, M., Fiori, C., Furlan, M., Marson, F., Montorsi, F., Morgia, G., Porreca, A., Roscigno, M., Schips, L., Selli, C., Simonato, A., Terrone, C., Vespasiani, G., Villari, D., Mari A, Campi R, Schiavina R, Amparore D, Antonelli A, Artibani W, Barale M, Bertini R, Borghesi M, Bove P, Brunocilla E, Capitanio U, Da Pozzo L, Daja J, Gontero P, Larcher A, Li Marzi V, Longo N, Mirone V, Montanari E, Pisano F, Porpiglia F, Simeone C, Siracusano S, Tellini R, Trombetta C, Volpe A, Ficarra V, Carini M, Minervini A, Mari, Andrea, Campi, Riccardo, Schiavina, Riccardo, Amparore, Daniele, Antonelli, Alessandro, Artibani, Walter, Barale, Maurizio, Bertini, Roberto, Borghesi, Marco, Bove, Pierluigi, Brunocilla, Eugenio, Capitanio, Umberto, Da Pozzo, Luigi, Daja, Julian, Gontero, Paolo, Larcher, Alessandro, Li Marzi, Vincenzo, Longo, Nicola, Mirone, Vincenzo, Montanari, Emanuele, Pisano, Francesca, Porpiglia, Francesco, Simeone, Claudio, Siracusano, Salvatore, Tellini, Riccardo, Trombetta, Carlo, Volpe, Alessandro, Ficarra, Vincenzo, Carini, Marco, Minervini, Andrea, Mari, A., Campi, R., Schiavina, R., Amparore, D., Antonelli, A., Artibani, W., Barale, M., Bertini, R., Borghesi, M., Bove, P., Brunocilla, E., Capitanio, U., Da Pozzo, L., Daja, J., Gontero, P., Larcher, A., Li Marzi, V., Longo, N., Mirone, V., Montanari, E., Pisano, F., Porpiglia, F., Simeone, C., Siracusano, S., Tellini, R., Trombetta, C., Volpe, A., Ficarra, V., Carini, M., Minervini, A., Altieri, V., Berardinelli, F., Celia, A., Costantini, E., Di Maida, F., Falsaperla, M., Fiori, C., Furlan, M., Marson, F., Montorsi, F., Morgia, G., Porreca, A., Roscigno, M., Schips, L., Selli, C., Simonato, A., Terrone, C., Vespasiani, G., Villari, D., Mari, A, Campi, R, Schiavina, R, Amparore, D, Antonelli, A, Artibani, W, Barale, M, Bertini, R, Borghesi, M, Bove, P, Brunocilla, E, Capitanio, U, Da Pozzo, L, Daja, J, Gontero, P, Larcher, A, Li Marzi, V, Longo, N, Mirone, V, Montanari, E, Pisano, F, Porpiglia, F, Simeone, C, Siracusano, S, Tellini, R, Trombetta, C, Volpe, A, Ficarra, V, Carini, M, Minervini, A, Altieri, V, Berardinelli, F, Celia, A, Costantini, E, Di Maida, F, Falsaperla, M, Fiori, C, Furlan, M, Marson, F, Montorsi, F, Morgia, G, Porreca, A, Roscigno, M, Schips, L, Selli, C, Simonato, A, Terrone, C, Vespasiani, G, and Villari, D

Subjects
partial nephrectomy, complications, Male, medicine.medical_specialty, renal cell carcinoma, nephron-sparing surgery, nomogram, robot-assisted partial nephrectomy, medicine.medical_treatment, Urology, 030232 urology & nephrology, complication, Logistic regression, Nephrectomy, 03 medical and health sciences, 0302 clinical medicine, Postoperative Complications, Interquartile range, Renal cell carcinoma, complications, nephron-sparing surgery, nomogram, partial nephrectomy, renal cell carcinoma, robot-assisted partial nephrectomy, Medicine, Humans, In patient, Prospective Studies, Stage (cooking), Aged, business.industry, Nomogram, postoperative surgical complications, partial nephrectomy, RECORd 2 project, Kidney Neoplasm, Nomogram, Middle Aged, medicine.disease, Kidney Neoplasms, Surgery, Editorial Commentary, Nomograms, Settore MED/24, 030220 oncology & carcinogenesis, partial nephrectomy, complications, Observational study, Female, Postoperative Complication, business, Human
Abstract

Objective To identify meaningful predictors and to develop a nomogram of postoperative surgical complications in patients treated with partial nephrectomy (PN). Patients and methods We prospectively evaluated 4308 consecutive patients who had surgical treatment for renal tumours, between 2013 and 2016, at 26 Italian urological centres (RECORd 2 project). A multivariable logistic regression for surgical complications was performed. A nomogram was created from the multivariable model. Internal validation processes were performed using bootstrapping with 1000 repetitions. Results Overall, 2584 patients who underwent PN were evaluated for the final analyses. The median (interquartile [IQR]) American Society of Anesthesiologists (ASA) score was 2 (2-3). In all, 72.4% of patients had clinical T1a (cT1a) stage tumours. The median (IQR) Preoperative Aspects and Dimensions Used for an Anatomical (PADUA) score was 7 (6-8). Overall, 34.3%, 27.7%, 38% of patients underwent open PN (OPN), laparoscopic PN (LPN), and robot-assisted PN (RAPN). Overall and major postoperative surgical complications were recorded in 10.2% and 2.5% of patients, respectively. At multivariable analysis, age, ASA score, cT2 vs cT1a stage, PADUA score, preoperative anaemia, OPN and LPN vs RAPN, were significant predictive factors of postoperative surgical complications. We used these variables to construct a nomogram for predicting the risk of postoperative surgical complications. At decision curve analysis, the nomogram led to superior outcomes for any decision associated with a threshold probability of >5%. Conclusion Several clinical predictors have been associated with postoperative surgical complications after PN. We used this information to develop and internally validate a nomogram to predict such risk.

Published
2019

24. Disease-specific and general health-related quality of life in newly diagnosed prostate cancer patients: The Pros-IT CNR study

Author

Angelo, Porreca, Marianna, Noale, Walter, Artibani, Pier Francesco Bassi, Filippo, Bertoni, Sergio, Bracarda, Giario Natale Conti, Renzo, Corvò, Mauro, Gacci, Pierpaolo, Graziotti, Magrini, STEFANO MARIA, Vincenzo, Mirone, Rodolfo, Montironi, Giovanni, Muto, Stefano, Pecoraro, Umberto, Ricardi, Elvio, Russi, Andrea, Tubaro, Vittorina, Zagonel, Gaetano, Crepaldi, Stefania, Maggi, Pierfrancesco, Bassi, Stefano Maria Magrini, Anna Rita Alitto, Enrica, Ambrosi, Alessandro, Antonelli, Cynthia, Aristei, Michele, Barbieri, Franco, Bardari, Lilia, Bardoscia, Salvina, Barra, Sara, Bartoncini, Umberto, Basso, Carlotta, Becherini, Rita, Bellavita, Franco, Bergamaschi, Stefania, Berlingheri, Berruti, Alfredo, Marco, Borghesi, Roberto, Bortolus, Valentina, Borzillo, Davide, Bosetti, Giuseppe, Bove, Pierluigi, Bove, Maurizio, Brausi, Alessio, Bruni, Giorgio, Bruno, Eugenio, Brunocilla, Alberto, Buffoli, BUGLIONE DI MONALE E BASTIA, Michela, Consuelo, Buttigliero, Giovanni, Cacciamani, Michela, Caldiroli, Giuseppe, Cardo, Giorgio, Carmignani, Giuseppe, Carrieri, Emanuele, Castelli, Elisabetta, Castrezzati, Gianpiero, Catalano, Susanna, Cattarino, Francesco, Catucci, Francolini Dario Cavallini, Ofelia, Ceccarini, Antonio, Celia, Francesco, Chiancone, Tommaso, Chini, Claudia, Cianci, Antonio, Cisternino, Devis, Collura, Franco, Corbella, Matteo, Corinti, Paolo, Corsi, Fiorenza, Cortese, Luigi, Corti, Cosimo de Nunzio, Olga, Cristiano, Rolando, M D'Angelillo, Luigi Da Pozzo, Daniele, D'Agostino, Carolina, D'Elia, Matteo, Dandrea, Michele De Angelis, Paolo De Angelis, Ottavio De Cobelli, Bernardino De Concilio, Antonello De Lisa, Stefano De Luca, Agostina De Stefani, Chiara Lucrezia Deantoni, Esposti Claudio Degli, Anna, Destito, Beatrice, Detti, Nadia Di Muzio, Andrea Di Stasio, Calogero Di Stefano, Danilo Di Trapani, Giuseppe, Difino, Sara, Falivene, Giuseppe, Farullo, Paolo, Fedelini, Ilaria, Ferrari, Francesco, Ferrau, Matteo, Ferro, Andrei, Fodor, Francesco, Fontanta, Francesco, Francesca, Giulio, Francolini, Paolo, Frata, Giovanni, Frezza, Pietro, Gabriele, Maria, Galeandro, Elisabetta, Garibaldi, Pietro Giovanni Gennari, Alessandro, Gentilucci, Alessandro, Giacobbe, Laura, Giussani, Giuseppe, Giusti, Paolo, Gontero, Alessia, Guarneri, Cesare, Guida, Alberto, Gurioli, Dorijan, Huqi, Ciro, Imbimbo, Gianluca, Ingrosso, Cinzia, Iotti, Corrado, Italia, Pierdaniele La Mattina, Enza, Lamanna, Luciana, Lastrucci, Grazia, Lazzari, Fabiola, Liberale, Giovanni, Liguori, Roberto, Lisi, Frank, Lohr, Riccardo, Lombardo, Jon A, J Lovisolo, Giuseppe Mario Ludovico, Nicola, Macchione, Francesca, Maggio, Michele, Malizia, Gianluca, Manasse, Giovanni, Mandoliti, Giovanna, Mantini, Luigi, Marafioti, Luisa, Marciello, Alberto Mario Marconi, Antonietta, Martilotta, Salvino, Marzano, Stefano, Masciullo, Gloria, Maso, Adele, Massenzo, Ercole, Mazzeo, Luigi, Mearini, Serena, Medoro, Rosa, Molè, Giorgio, Monesi, Emanuele, Montanari, Franco, Montefiore, Giampaolo, Montesi, Giuseppe, Morgia, Gregorio, Moro, Giorgio, Muscas, Daniela, Musio, Paolo, Muto, Giovanni, Muzzonigro, Giorgio, Napodano, Carlo Luigi Augusto Negro, Mattia, Nidini, Maria, Ntreta, Marco, Orsatti, Carmela, Palazzolo, Isabella, Palumbo, Alessandro, Parisi, Paolo, Parma, Nicola, Pavan, Martina, Pericolini, Francesco, Pinto, Antonio, Pistone, Valerio, Pizzuti, Angelo, Platania, Caterina, Polli, Giorgio, Pomara, Elisabetta, Ponti, Antonio Benito Porcaro, Francesco, Porpiglia, Dario, Pugliese, Armin, Pycha, Giuseppe, Raguso, Andrea, Rampini, Donato Franco Randone, Valentina, Roboldi, Marco, Roscigno, Maria Paola Ruggieri, Giuseppe, Ruoppo, Roberto, Sanseverino, Anna, Santacaterina, Michele, Santarsieri, Riccardo, Santoni, Sarah, Scagliarini, Giorgio Vittorio Scagliotti, Mauro, Scanzi, Marcello, Scarcia, Riccardo, Schiavina, Alessandro, Sciarra, Carmine, Sciorio, Tindaro, Scolaro, Salvatore, Scuzzarella, Oscar, Selvaggio, Armando, Serao, Sergio, Serni, Marco Andrea Signor, Mauro, Silvani, Giovanni, Silvano, Franco, Silvestris, Simeone, Claudio, Valeria, Simone, Girolamo, Spagnoletti, Matteo Giulio Spinelli, Luigi, Squillace, Vincenzo, Tombolini, Mariastella, Toninelli, Triggiani, Luca, Alberto, Trinchieri, Luca Eolo Trodella, Lucio, Trodella, Carlo, Trombetta, Lidia, Tronnolone, Marcello, Tucci, Daniele, Urzì, Riccardo, Valdagni, Maurizio, Valeriani, Maurizio, Vanoli, Elisabetta, Vitali, Alessandro, Volpe, Stefano, Zaramella, Guglielmo, Zeccolini, Giampaolo, Zini, Porreca, Angelo, Noale, Marianna, Artibani, Walter, Bassi, Pier Francesco, Bertoni, Filippo, Bracarda, Sergio, Conti, Giario Natale, Corvò, Renzo, Gacci, Mauro, Graziotti, Pierpaolo, Magrini, Stefano Maria, Mirone, Vincenzo, Montironi, Rodolfo, Muto, Giovanni, Pecoraro, Stefano, Ricardi, Umberto, Russi, Elvio, Tubaro, Andrea, Zagonel, Vittorina, Crepaldi, Gaetano, Maggi, Stefania, Gaetano, Crepaldi, Umberto, Basso, Luigi, Corti, D'Agostino, Daniele, Matteo, Dandrea, Davide, Bosetti, Gianpiero, Catalano, Ottavio, De Cobelli, Lucrezia, Deantoni Chiara, Nadia, Di Muzio, Ferro, Matteo, Andrei, Fodor, Pierdaniele, La Mattina, Emanuele, Montanari, Barbieri, Michele, Valentina, Borzillo, Chiancone, Francesco, Sara, Falivene, Paolo, Fedelini, Imbimbo, Ciro, Paolo, Muto, Sarah, Scagliarini, Giovanni, Muzzonigro, Enrica, Ambrosi, Alessandro, Antonelli, Lilia, Bardoscia, Stefania, Berlingheri, Alfredo, Berruti, Alberto, Buffoli, Michela, Buglione, Mauro, Scanzi, Elisabetta, Castrezzati, Paolo, Frata, Giulio, Francolini, Beatrice, Detti, Tommaso, Chini, Carlotta, Becherini, Olga, Cristiano, Cesare, Guida, Sara, Bartoncini, Consuelo, Buttigliero, Emanuele, Castelli, Devis, Collura, Stefano, De Luca, Pietro, Gabriele, Elisabetta, Garibaldi, Alessandro, Giacobbe, Paolo, Gontero, Alessia, Guarneri, Alberto, Gurioli, Francesco, Porpiglia, Franco, Randone Donato, Vittorio, Scagliotti Giorgio, Cynthia, Aristei, Rita, Bellavita, Isabella, Palumbo, Franco, Bardari, Augusto, Negro Carlo Luigi, Franco, Bergamaschi, Maria, Galeandro, Cinzia, Iotti, Giuseppe, Raguso, Paola, Ruggieri Maria, Giuseppe, Ruoppo, Marco, Borghesi, Eugenio, Brunocilla, Claudio, Degli Esposti, Giovanni, Frezza, Michele, Malizia, Maria, Ntreta, Alessandro, Parisi, Riccardo, Schiavina, Roberto, Bortolu, Giuseppe, Bove, Antonio, Cisternino, Carrieri, Giuseppe, Giuseppe, Difino, Oscar, Selvaggio, Maurizio, Brausi, Alessio, Bruni, Frank, Lohr, Ercole, Mazzeo, Enza, Lamanna, Calogero, Di Stefano, Giorgio, Bruno, Michela, Caldiroli, Ilaria, Ferrari, Laura, Giussani, Lovisolo Jon, A. J., Mario, Marconi Alberto, Giuseppe, Cardo, Mario, Ludovico Giuseppe, Marcello, Scarcia, Giorgio, Carmignani, Salvina, Barra, Dario, Cavallini Francolini, Franco, Corbella, Ofelia, Ceccarini, Luigi, Da Pozzo, Agostina, De Stefani, Corrado, Italia, Stefano, Masciullo, Valentina, Roboldi, Marco, Roscigno, Antonio, Celia, Bernardino, De Concilio, Claudia, Cianci, Francesco, Francesca, Giorgio, Pomara, Michele, Santarsieri, Fiorenza, Cortese, Andrea, Di Stasio, Franco, Montefiore, Armando, Serao, D'Elia, Carolina, Armin, Pycha, Dorijan, Huqi, Paolo, De Angeli, Nicola, Macchione, Francesco, Fontanta, Giorgio, Monesi, Antonello, De Lisa, Giuseppe, Giusti, Giorgio, Musca, Anna, Destito, Rosa, Molè, Danilo, Di Trapani, Francesco, Ferrau, Carmela, Palazzolo, Angelo, Platania, Anna, Santacaterina, Grazia, Lazzari, Fabiola, Liberale, Gregorio, Moro, Giovanni, Liguori, Nicola, Pavan, Francesca, Maggio, Marco, Orsatti, Giovanni, Mandoliti, Giampaolo, Montesi, Luigi, Marafioti, Antonietta, Martilotta, Adele, Massenzo, Luisa, Marciello, Salvino, Marzano, Caterina, Polli, Gloria, Maso, Serena, Medoro, Giuseppe, Morgia, Napodano, Giorgio, Pistone, Antonio, Roberto, Sanseverino, Mattia, Nidini, Paolo, Parma, Valerio, Pizzuti, Sciorio, Carmine, Scuzzarella, Salvatore, Tindaro, Scolaro, Porreca A, Noale M, Artibani W, Bassi PF, Bertoni F, Bracarda S, Conti GN, Corvò R, Gacci M, Graziotti P, Magrini SM, Mirone V, Montironi R, Muto G, Pecoraro S, Ricardi U, Russi E, Tubaro A, Zagonel V, Crepaldi G, Maggi S, Crepaldi G, Maggi S, Noale M, Porreca A, Artibani W, Bassi P, Bracarda S, Conti GN, Corvò R, Graziotti P, Russi E, Mirone V, Montironi R, Bertoni F, Gacci M, Magrini SM, Muto G, Pecoraro S, Ricardi U, Tubaro A, Zagonel V, Alitto AR, Ambrosi E, Antonelli A, Aristei C, Barbieri M, Bardari F, Bardoscia L, Barra S, Bartoncini S, Basso U, Becherini C, Bellavita R, Bergamaschi F, Berlingheri S, Berruti A, Borghesi M, Bortolus R, Borzillo V, Bosetti D, Bove G, Bove P, Brausi M, Bruni A, Bruno G, Brunocilla E, Buffoli A, Buglione M, Buttigliero C, Cacciamani G, Caldiroli M, Cardo G, Carmignani G, Carrieri G, Castelli E, Castrezzati E, Catalano G, Cattarino S, Catucci F, Cavallini FD, Ceccarini O, Celia A, Chiancone F, Chini T, Cianci C, Cisternino A, Collura D, Corbella F, Corinti M, Corsi P, Cortese F, Corti L, de Nunzio C, Cristiano O, D'Angelillo RM, Da Pozzo L, D'agostino D, D'Elia C, Dandrea M, De Angelis M, De Angelis P, De Cobelli O, De Concilio B, De Lisa A, De Luca S, De Stefani A, Deantoni CL, Degli EC, Destito A, Detti B, Di Muzio N, Di Stasio A, Di Stefano C, Di Trapani D, Difino G, Falivene S, Farullo G, Fedelini P, Ferrari I, Ferrau F, Ferro M, Fodor A, Fontanta F, Francesca F, Francolini G, Frata P, Frezza G, Gabriele P, Galeandro M, Garibaldi E, Gennari PG, Gentilucci A, Giacobbe A, Giussani L, Giusti G, Gontero P, Guarneri A, Guida C, Gurioli A, Huqi D, Imbimbo C, Ingrosso G, Iotti C, Italia C, La Mattina P, Lamanna E, Lastrucci L, Lazzari G, Liberale F, Liguori G, Lisi R, Lohr F, Lombardo R, Lovisolo JAJ, Ludovico GM, Macchione N, Maggio F, Malizia M, Manasse G, Mandoliti G, Mantini G, Marafioti L, Marciello L, Marconi AM, Martilotta A, Marzano S, Masciullo S, Maso G, Massenzo A, Mazzeo E, Mearini L, Medoro S, Molè R, Monesi G, Montanari E, Montefiore F, Montesi G, Morgia G, Moro G, Muscas G, Musio D, Muto P, Muzzonigro G, Napodano G, Negro CLA, Nidini M, Ntreta M, Orsatti M, Palazzolo C, Palumbo I, Parisi A, Parma P, Pavan N, Pericolini M, Pinto F, Pistone A, Pizzuti V, Platania A, Polli C, Pomara G, Ponti E, Porcaro AB, Porpiglia F, Pugliese D, Pycha A, Raguso G, Rampini A, Randone DF, Roboldi V, Roscigno M, Ruggieri MP, Ruoppo G, Sanseverino R, Santacaterina A, Santarsieri M, Santoni R, Scagliarini S, Scagliotti GV, Scanzi M, Scarcia M, Schiavina R, Sciarra A, Sciorio C, Scolaro T, Scuzzarella S, Selvaggio O, Serao A, Serni S, Signor MA, Silvani M, Silvano G, Silvestris F, Simeone C, Simone V, Spagnoletti G, Spinelli MG, Squillace L, Tombolini V, Toninelli M, Triggiani L, Trinchieri A, Trodella LE, Trodella L, Trombetta C, Tronnolone L, Tucci M, Urzì D, Valdagni R, Valeriani M, Vanoli M, Vitali E, Volpe A, Zaramella S, Zeccolini G, Zini G, Porreca, A., Noale, M., Artibani, W., Bassi, P. F., Bertoni, F., Bracarda, S., Conti, G. N., Corvo, R., Gacci, M., Graziotti, P., Magrini, S. M., Mirone, V., Montironi, R., Muto, G., Pecoraro, S., Ricardi, U., Russi, E., Tubaro, A., Zagonel, V., Crepaldi, G., Maggi, S., Alitto, A. R., Ambrosi, E., Antonelli, A., Aristei, C., Barbieri, M., Bardari, F., Bardoscia, L., Barra, S., Bartoncini, S., Basso, U., Becherini, C., Bellavita, R., Bergamaschi, F., Berlingheri, S., Berruti, A., Borghesi, M., Bortolus, R., Borzillo, V., Bosetti, D., Bove, G., Bove, P., Maurizio, B., Alessio, B., Giorgio, B., Eugenio, B., Alberto, B., Michela, B., Consuelo, B., Giovanni, C., Michela, C., Giuseppe, C., Giorgio, C., Emanuele, C., Elisabetta, C., Gianpiero, C., Susanna, C., Catucci, F., Dario, C. F., Ofelia, C., Antonio, C., Francesco, C., Tommaso, C., Claudia, C., Devis, C., Franco, C., Matteo, C., Paolo, C., Fiorenza, C., Luigi, C., Cosimo, N., Cristiano, O., D'Angelillo, R. M., Da Pozzo, L., D'Agostino, D., D'Elia, C., Dandrea, M., De Angelis, M., De Angelis, P., De Cobelli, O., De Concilio, B., De Lisa, A., De Luca, S., De Stefani, A., Deantoni, C. L., Degli, E. C., Destito, A., Detti, B., Di Muzio, N., Di Stasio, A., Di Stefano, C., Di Trapani, D., Difino, G., Falivene, S., Farullo, G., Fedelini, P., Ferrari, I., Ferrau, F., Ferro, M., Fodor, A., Fontanta, F., Francesca, F., Francolini, G., Frata, P., Frezza, G., Gabriele, P., Galeandro, M., Garibaldi, E., Gennari, P. G., Gentilucci, A., Giacobbe, A., Giussani, L., Giusti, G., Gontero, P., Guarneri, A., Guida, C., Gurioli, A., Huqi, D., Imbimbo, C., Ingrosso, G., Iotti, C., Italia, C., La Mattina, P., Lamanna, E., Lastrucci, L., Lazzari, G., Liberale, F., Liguori, G., Lisi, R., Lohr, F., Lombardo, R., Lovisolo, J. A. J., Ludovico, G. M., Macchione, N., Maggio, F., Malizia, M., Manasse, G., Mandoliti, G., Mantini, G., Marafioti, L., Marciello, L., Marconi, A. M., Martilotta, A., Marzano, S., Masciullo, S., Maso, G., Massenzo, A., Mazzeo, E., Mearini, L., Medoro, S., Mole, R., Monesi, G., Montanari, E., Montefiore, F., Montesi, G., Morgia, G., Moro, G., Muscas, G., Musio, D., Muto, P., Muzzonigro, G., Napodano, G., Negro, C. L. A., Nidini, M., Ntreta, M., Orsatti, M., Palazzolo, C., Palumbo, I., Parisi, A., Parma, P., Pavan, N., Pericolini, M., Pinto, F., Pistone, A., Pizzuti, V., Platania, A., Polli, C., Pomara, G., Ponti, E., Porcaro, A. B., Porpiglia, F., Pugliese, D., Pycha, A., Raguso, G., Rampini, A., Randone, D. F., Roboldi, V., Roscigno, M., Ruggieri, M. P., Ruoppo, G., Sanseverino, R., Santacaterina, A., Santarsieri, M., Santoni, R., Scagliarini, S., Scagliotti, G. V., Scanzi, M., Scarcia, M., Schiavina, R., Sciarra, A., Sciorio, C., Scolaro, T., Scuzzarella, S., Selvaggio, O., Serao, A., Serni, S., Signor, M. A., Silvani, M., Silvano, G., Silvestris, F., Simeone, C., Simone, V., Spagnoletti, G., Spinelli, M. G., Squillace, L., Tombolini, V., Toninelli, M., Triggiani, L., Trinchieri, A., Trodella, L. E., Trodella, L., Trombetta, C., Tronnolone, L., Tucci, M., Urzi, D., Valdagni, R., Valeriani, M., Vanoli, M., Vitali, E., Volpe, A., Zaramella, S., Zeccolini, G., Zini, G., Porreca, A, Noale, M, Artibani, W, Bassi, P, Bertoni, F, Bracarda, S, Conti, G, Corvò, R, Gacci, M, Graziotti, P, Magrini, S, Mirone, V, Montironi, R, Muto, G, Pecoraro, S, Ricardi, U, Russi, E, Tubaro, A, Zagonel, V, Crepaldi, G, Maggi, S, and Da Pozzo, L

Subjects
Male, 030232 urology & nephrology, Severity of Illness Index, Prostate cancer, 0302 clinical medicine, Quality of life, Activities of Daily Living, Diagnosis, Medicine, Age Factor, Prospective Studies, Prospective cohort study, Settore MED/36 - DIAGNOSTICA PER IMMAGINI E RADIOTERAPIA, Age Factors, Pros-IT CNR study, General Medicine, Health Survey, Middle Aged, Neoadjuvant Therapy, 3. Good health, Italy, 030220 oncology & carcinogenesis, lcsh:R858-859.7, Regression Analysis, Public Health, Human, Diagnosi, prostate cancer, survival, quality of life, medicine.medical_specialty, lcsh:Computer applications to medicine. Medical informatics, Regression Analysi, 03 medical and health sciences, Percutaneous Coronary Intervention, Internal medicine, Severity of illness, Humans, Aged, Cancer staging, business.industry, Research, Environmental and Occupational Health, Public Health, Environmental and Occupational Health, Prostatic Neoplasms, Cancer, medicine.disease, Health Surveys, Comorbidity, Quality of Life, Prospective Studie, Settore MED/24, Prostatic Neoplasm, business, Sexual function
Abstract

Background The National Research Council (CNR) prostate cancer monitoring project in Italy (Pros-IT CNR) is an observational, prospective, ongoing, multicentre study aiming to monitor a sample of Italian males diagnosed as new cases of prostate cancer. The present study aims to present data on the quality of life at time prostate cancer is diagnosed. Methods One thousand seven hundred five patients were enrolled. Quality of life is evaluated at the time cancer was diagnosed and at subsequent assessments via the Italian version of the University of California Los Angeles-Prostate Cancer Index (UCLA-PCI) and the Short Form Health Survey (SF-12). Results At diagnosis, lower scores on the physical component of the SF-12 were associated to older ages, obesity and the presence of 3+ moderate/severe comorbidities. Lower scores on the mental component were associated to younger ages, the presence of 3+ moderate/severe comorbidities and a T-score higher than one. Urinary and bowel functions according to UCLA-PCI were generally good. Almost 5% of the sample reported using at least one safety pad daily to control urinary loss; less than 3% reported moderate/severe problems attributable to bowel functions, and sexual function was a moderate/severe problem for 26.7%. Diabetes, 3+ moderate/severe comorbidities, T2 or T3-T4 categories and a Gleason score of eight or more were significantly associated with lower sexual function scores at diagnosis. Conclusions Data collected by the Pros-IT CNR study have clarified the baseline status of newly diagnosed prostate cancer patients. A comprehensive assessment of quality of life will allow to objectively evaluate outcomes of different profile of care.

Published
2018

25. Similar efficacy of intra-articular hyaluronic acid injections and other biologically active injections in patients with early stages knee osteoarthritis: a level I meta-analysis.

Author

Migliorini F, Schäfer L, Pilone M, Bell A, Simeone F, and Maffulli N

Subjects
Female, Humans, Injections, Intra-Articular, Patient Reported Outcome Measures, Randomized Controlled Trials as Topic, Treatment Outcome, Viscosupplements administration & dosage, Hyaluronic Acid administration & dosage, Osteoarthritis, Knee drug therapy
Abstract

Introduction: The present meta-analysis compared the efficacy of intra-articular hyaluronic acid (HA) injections in patients with early to mild knee osteoarthritis (OA) (Kellgren Lawrence I-II) versus other commonly injected biologically active compounds using patient-reported outcome measures (PROMs). The outcomes of interest were the visual analogue scale (VAS) and the Western Ontario McMaster Osteo-Arthritis Index (WOMAC) scores., Methods: This study was conducted according to the 2020 PRISMA statement. In April 2024, PubMed, Web of Science, Google Scholar, and Embase were accessed without time constraints. All the randomised controlled trials (RCTs) investigating the efficacy of intra-articular HA injections in the early stages of knee OA were accessed. Data concerning the VAS, WOMAC, and related subscales were collected at baseline and the last follow-up. Only studies clearly stated the degrees of advancement of OA using the Kellgren-Lawrence scoring system were used., Results: The literature search resulted in four RCTs (390 patients). The mean length of the last follow-up was 7.5 ± 3.0 months. 72.3% (282 of 390) of the patients were women. The mean age of the patients was 58.1 ± 3.2 years, and the mean BMI was 27.3 ± 3.2 kg/m 2 . At the last follow-up, no difference was found between HA and the control group in VAS, WOMAC, and related subscales., Conclusion: In patients with early to mild knee osteoarthritis, the current level of evidence suggests that intra-articular injections using HA performed similarly to other biologically active compounds commonly injected in the knee joint for a minimum of three months., Level of Evidence: Level I, meta-analysis., Competing Interests: Declarations. Conflict of interest: The authors declare that they have any competing interests in this article. Ethical approval: This study complies with ethical standards. Consent to publish: Not applicable. Consent to participate: Not applicable. Registration and protocol: The present review was not registered., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Published
2024
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26. Sacroiliac joint pain: what treatment and when.

Author

Cocconi F, Maffulli N, Bell A, Memminger MK, Simeone F, and Migliorini F

Subjects
Humans, Arthralgia therapy, Pain Management methods, Injections, Intra-Articular, Sacroiliac Joint, Low Back Pain therapy
Abstract

Introduction: Spinal and non-spinal pathologies can cause low back pain. Non-spinal sources of low back pain include the sacroiliac joint (SIJ) and the hip. SIJ pain can be treated either conservatively or surgically. Current strategies for managing sacroiliac joint pain are debated, and limited evidence exists., Areas Covered: The present expert opinion updates current evidence on conservative and surgical modalities for SIJ pain., Expert Opinion: Surgical management for SIJ pain is effective. However, it exposes patients to surgery and, therefore, related complications. Conservative management may be implemented in patients with moderate SIJ pain, with less than six months of symptoms, or not eligible for surgery. Several noninvasive modalities are available, mostly centered on intra-articular injections. Corticosteroids, platelet-rich plasma, and stem cells have only midterm lasting effects, at most for nine months. Radiofrequency ablation is another methodology for pain relief. Both continuous and pulsatile radiofrequency ablation are associated with good outcomes. SIJ fusion can be performed using different techniques; however, a clear recommendation on the most appropriate modality for the management of SIJ pain is still debated.

Published
2024
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27. Clinical relevance of patient-reported outcome measures in patients who have undergone total hip arthroplasty: a systematic review.

Author

Migliorini F, Maffulli N, Memminger MK, Simeone F, Rath B, and Huber T

Subjects
Humans, Minimal Clinically Important Difference, Clinical Relevance, Patient Reported Outcome Measures, Arthroplasty, Replacement, Hip
Abstract

Introduction: In orthopaedic research, it is crucial to determine changes that are statistically significant and clinically meaningful. One approach to accomplish this is by calculating the Minimal Clinically Important Difference (MCID), the Clinically Important Differences (CID), the Minimum Detectable Change (MDC), the Minimal Important Change (MIC), and the Patient Acceptable Symptom State (PASS) values. These tools assist medical professionals in comprehending the patient's viewpoint, enabling them to establish treatment objectives that align with patients' desires and expectations. The present systematic review investigated the MCID, MIC, CID, MDC, and PASS of the most used PROMs to assess patients who have undergone THA., Methods: This systematic review followed the 2020 PRISMA guidelines. Web of Science, Embase, and PubMed were accessed in March 2024 without time constraints or additional filters. All the clinical investigations which evaluated data tools (MCID, MIC, CID, MDC, and PASS) to assess the clinical relevance of PROMs in THA were accessed. Articles in Spanish, Italian, German, and English were eligible. Studies with levels of evidence I to III were eligible., Results: Data from 100,824 patients were collected. All relevant demographic data were analysed and summarised. In addition, the MCID, MIC, CID, MDC and PASS of the COMI, HOOS, SF-36, OHS, Oxford-12, PROMIS-PF, SF-12, and WOMAC scores for THA were determined., Conclusion: Current evidence recommends to collect MCIDs based on anchors routinely. These values should be used as complementary tools to determine the clinical effectiveness of a treatment instead of solely relying on statistically significant improvements., Level of Evidence: Level IV, systematic review and meta-analysis., Competing Interests: Declarations. Conflict of interest: The authors declare that they have any competing interests in this article. Ethical approval: This study complies with ethical standards. Consent to participate: Not applicable. Consent to publish: Not applicable. Registration and protocol: The present review was not registered., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Published
2024
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28. Pharmacological management of secondary chronic spinal cord injury: a systematic review.

Author

Migliorini F, Cocconi F, Schäfer L, Simeone F, Jeyaraman M, and Maffulli N

Subjects
Humans, 4-Aminopyridine therapeutic use, Baclofen therapeutic use, Chronic Disease, Riluzole therapeutic use, Spinal Cord Injuries complications, Spinal Cord Injuries drug therapy
Abstract

Introduction: Spinal cord injury (SCI) may bring lifelong consequences for affected patients and a high financial burden to the health care system., Source of Data: Published peer-reviewed scientific articles identified from EMBASE, Google Scholar, PubMed and Scopus., Areas of Agreement: Surgery and blood pressure management are the main targets in acute SCI to avoid secondary damage., Areas of Controversy: The management of secondary chronic SCI is challenging, with unpredictable outcomes., Growing Points: Given the lack of consensus on pharmacological therapy for acute and secondary chronic SCI, the present study analyses the currently available drugs and treatment options to manage secondary chronic SCI., Areas Timely for Developing Research: Different approaches exist for the pharmacological management of secondary chronic SCI. One of the most investigated drugs, 4-aminopyridine, improves central motor conduction and shows improvement in neurological signs. Positive results in different areas have been observed in patients receiving the anti-spastic drugs tizanidine and baclofen or Granulocyte colony-stimulating factor. Growth hormone showed only minimal or no significant effects, and the therapy of secondary chronic SCI with riluzole has been poorly researched to date., (© The Author(s) 2024. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)

Published
2024
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29. Return to Sport Following Arthroscopic Management of Femoroacetabular Impingement: A Systematic Review.

Author

Lucenti L, Maffulli N, Bardazzi T, Saggini R, Memminger M, Simeone F, and Migliorini F

Abstract

Background: Femoroacetabular impingement (FAI) is common. The present systematic review updates the current evidence on return to sport (RTS) in patients who have undergone arthroscopic surgery for FAI in any of its variants (CAM, pincer, or both). Methods: The outcomes of interest were sports-related patient-reported outcome measures (PROMs) and the level and time to RTS. All available clinical studies concerning the RTS following arthroscopic management of FAI were considered. In July 2024, the following databases were accessed following the PRISMA guidelines: Embase, Web of Science, and PubMed. Only studies with a minimum of six months of follow-up were eligible. Results: From 1245 initially identified articles, 43 studies (4103 patients) met the inclusion criteria, in which 32.1% (1317 of 4103 patients) were women. The mean length of follow-up was 33.7 ± 15.8 months. The mean age was 28.1 ± 7.2 years, the mean BMI was 24.7 ± 6.4 kg/m 2 , and 79.6% ± 27.8% of patients returned to sport at the same or higher level at a mean of 14.3 ± 9.6 months. The mean time away from sports was 8.0 ± 3.3 months. Conclusion: Arthroscopic management for FAI leads to a high rate of RTS, with approximately 80% of patients returning to their preinjury level. Future research should focus on standardised definitions of RTS, sport-specific rehabilitation protocols, and the influence of deformity and procedures on RTS.

Published
2024
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30. Management of Distal Femoral Non-union: A Systematic Review.

Author

Migliorini F, Schäfer L, Simeone F, Vaish A, Bhadani JS, and Vaishya R

Abstract

Introduction: Managing distal femur fracture nonunion is complex, with unpredictable results. The present investigation systematically updates current evidence, reviews existing modalities, innovations and related outcomes, and discusses future perspectives on the management of nonunion of the distal femur., Methods: This study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the 2020 PRISMA statement. In April 2024, PubMed, Web of Science, Google Scholar, and Embase were accessed without time constraints. No additional filters were used in the database search. All the clinical studies investigating treatment options for nonunion of distal femur fractures were accessed., Results: 35 clinical studies (832 patients) were included. Of them, 34.2% (239 of 698 patients) reported an open fracture, and 24.5% (78 of 319 patients) reported infection at the fracture site. The mean length of the follow-up was 28.9 ± 13.2 months. The mean age of the patients was 53.8 ± 14.7 years., Conclusion: 84.5% (703 of 832) of patients reached complete union without major complications, and 3.8% (32 of 832) reached complete union with major complications at a mean of 21.7 ± 20.9 months. 8.7% (72 of 832) patients showed signs of persistent non-union., Level of Evidence: Level III, systematic review., Supplementary Information: The online version contains supplementary material available at 10.1007/s43465-024-01205-4., Competing Interests: Conflict of InterestThe authors declare that they have any competing interests in this article., (© Indian Orthopaedics Association 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Published
2024
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31. Predictors of success of pharmacological management in patients with chronic lower back pain: systematic review.

Author

Baroncini A, Maffulli N, Mian M, Vaishya R, Simeone F, and Migliorini F

Subjects
Humans, Conservative Treatment, Disability Evaluation, Pain Measurement, Surveys and Questionnaires, Chronic Pain drug therapy, Low Back Pain diagnosis, Low Back Pain drug therapy
Abstract

Background: Conservative management is recommended as the first therapeutic step in chronic low back pain (LBP), but there is no available evidence regarding the possible effect of patients' baseline characteristics on the therapeutic outcomes. A systematic review of the literature was performed to investigate this point., Methods: In February 2024, all the level I studies investigating the role of pharmacological management for chronic LBP were accessed. Data concerning the patient demographic at baseline were collected: number of patients and related mean BMI and age, duration of the symptoms, duration of the follow-up, percentage of females, Numeric Rating Scale (NRS), the Roland Morris Disability Questionnaire (RMQ), Oswestry Disability Index (ODI). The outcomes at the last follow-up were evaluated through NRS, RMQ, and ODI. A multiple linear model regression diagnostic through the Pearson Product-Moment Correlation Coefficient (r) was used., Results: Data from 47 articles (9007 patients) were obtained. The analysis yielded the following significant associations: age at baseline and NRS at follow-up (r = - 0.22; P = 0.04), NRS at baseline with NRS (r = 0.26; P = 0.03) and RMQ (r = - 0.58; P = 0.02) at follow-up, RMQ at baseline and the same at follow-up (r = 0.69; P = 0.0001)., Conclusion: Older age, higher BMI, presence of comorbidities, higher ODI and a long history of symptoms or surgical treatments do not reduce the efficacy of pharmacological management of chronic LBP. However, pharmacological therapy is not an effective option for patients with high baseline RMQ., Level of Evidence: I systematic review of RCTs., (© 2024. The Author(s).)

Published
2024
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32. Functional alignment in robotic-assisted total knee arthroplasty: a systematic review.

Author

Migliorini F, Pilone M, Schäfer L, Simeone F, Bell A, and Maffulli N

Subjects
Humans, Aged, Arthroplasty, Replacement, Knee methods, Robotic Surgical Procedures methods
Abstract

Purpose: The present study systematically reviewed current evidence on functional alignment (FA) in robotic total knee arthroplasty (TKA), discussing advantages and limitations, possible pitfalls, and prospects., Methods: This study was conducted according to the 2020 PRISMA statement. In August 2023, the following databases were accessed: PubMed, Web of Science, Google Scholar, and Embase with no additional filters or time constraints. All the clinical studies investigating functional alignment in robotic TKA were accessed. Only studies published in peer-reviewed journals were considered. The risk of bias was evaluated following the guidelines in the Cochrane Handbook for Systematic Reviews of Interventions. Non-randomized controlled trials (non-RCTs) were evaluated using the Risk of Bias in Nonrandomised Studies of Interventions (NRSI) (ROBINS-I) tool., Results: Data from 1198 patients (seven studies) were retrieved. The mean length of the follow-up was 17.1 ± 6.4 months. The mean age was 67.2 ± 5.4 years, and the mean BMI was 30.9 ± 2.7 kg/m 2 ., Conclusion: FA might improve resection accuracy, implant alignment, and gap balancing in TKA, and additional high-quality clinical trials are necessary to properly establish the superiority of FA to other alignment techniques in TKA. Long-term clinical trials are needed to investigate the impact of FA on implant survivorship., Level of Evidence: Level IV, systematic review and meta-analysis., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Published
2024
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33. Minimal clinically important difference (MCID), substantial clinical benefit (SCB), and patient-acceptable symptom state (PASS) in patients who have undergone total knee arthroplasty: a systematic review.

Author

Migliorini F, Maffulli N, Schäfer L, Simeone F, Bell A, and Hofmann UK

Abstract

Background: The present systematic review investigated the minimal clinically important difference (MCID), substantial clinical benefit (SCB), and patient-acceptable symptom state (PASS) of several frequent and established PROMs used to assess patients who have undergone TKA. This study was conducted according to the 2020 PRISMA statement., Methods: In September 2023, PubMed, Web of Science, and Embase were accessed with no time constraint All clinical studies investigating tools to assess the clinical relevance of PROMs used to evaluate patients having received TKA were accessed. Only studies which evaluated the MCID, PASS, or SCB were eligible. The PROMs of interest were the Forgotten Joint Score-12 (FJS-12), the Oxford Knee Score (OKS), the Knee Injury and Osteoarthritis Outcome Score (KOOS) and its related subscales activity of daily living (ADL), pain, quality of life (QoL), sports and recreational activities, and symptoms, the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) score, the Knee Society Score (KSS) and related function score, and the Short Form-12 (SF-12) and Short Form-36 (SF-36)., Results: Data from 29,737 patients were collected. The overall risk of bias was low to moderate. The great variability of thresholds for MCID, SCB and PASS between questionnaires but also between investigated aspects was noted, whereby MCIDs for the SF-36 appear lower than for knee-specific questionnaires., Conclusion: Despite its critical role from a patient's perspective, the dimension of SCB is still neglected in the literature. Moreover, thresholds for the different concepts need to be condition-specific. We encourage authors to specifically report such data in future studies and to adhere to previously reported definitions to allow future comparison. Level of evidence Level IV, systematic review and meta-analysis., (© 2024. The Author(s).)

Published
2024
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34. Level I of evidence does not support manual lymphatic drainage for total knee arthroplasty: a meta-analysis.

Author

Migliorini F, Schäfer L, Bertini FA, Memminger MK, Simeone F, Giorgino R, and Maffulli N

Subjects
Male, Female, Humans, Aged, Manual Lymphatic Drainage, Knee Joint surgery, Edema, Pain, Postoperative, Range of Motion, Articular, Arthroplasty, Replacement, Knee
Abstract

It is unclear whether manual lymphatic drainage (MLD) following primary total knee arthroplasty (TKA) is effective in reducing pain and swelling and improving knee function. The present study investigated the efficacy of MLD after TKA. The outcomes of interest are the range of motion (ROM), pain (visual analogue scale, VAS), and circumference of the lower leg. This meta-analysis was conducted according to the 2020 PRISMA statement. In November 2023, the following databases were accessed: PubMed, Web of Science, Google Scholar, and Embase, with no time constraint. Only level I evidence studies, according to the Oxford Centre of Evidence-Based Medicine, were considered. All the randomised controlled trials (RCTs) comparing patients who have received MLD versus a group of patients who did not undergo MLD following primary TKA were accessed. Data from four RCTs (197 TKAs) were retrieved. 67% (132 of 197 patients) were women. The mean length of follow-up was 7.0 ± 5.8 weeks. The mean age of the patients was 69.6 ± 2.7 years, and the mean BMI was 28.7 ± 0.9 kg/m 2 . At baseline, between-group comparability was evidenced in the male:female ratio, mean age, mean BMI, knee flexion, and VAS. No difference was found in flexion (P = 0.7) and VAS (P = 0.3). No difference was found in the circumference of the thigh (P = 0.8), knee (P = 0.4), calf (P = 0.4), and ankle (P = 0.3). The current level I of evidence does not support the use of MLD in primary TKA., (© 2023. The Author(s).)

Published
2023
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35. Head, acetabular liner composition, and rate of revision and wear in total hip arthroplasty: a Bayesian network meta-analysis.

Author

Merfort R, Maffulli N, Hofmann UK, Hildebrand F, Simeone F, Eschweiler J, and Migliorini F

Subjects
Humans, Female, Middle Aged, Aged, Male, Hip Joint surgery, Bayes Theorem, Network Meta-Analysis, Prosthesis Failure, Polyethylene, Prosthesis Design, Arthroplasty, Replacement, Hip methods, Hip Prosthesis
Abstract

Total hip arthroplasty (THA) is a common procedure for patients suffering from hip pain e.g. from osteoarthritis, osteonecrosis, or hip fractures. The satisfaction of patients undergoing THA is influenced by the choice of implant type and material, with one key factor being the selection of the appropriate material combination for the bearing surface. In this Bayesian network meta-analysis, we investigated the impact of material combinations for the bearing surface on the longevity of hip implants. The wear penetration rate per year and the total wear penetration in the liner resulting from different material combinations, as well as the survival rate at last follow-up, were examined. We analyzed a total of 663,038 THAs, with 55% of patients being women. Mean patient age was 59.0 ± 8.1 years and mean BMI 27.6 ± 2.6 kg/m 2 . The combination of an aluminium oxide (Al 2 O 3 ) head and an Al 2 O 3 liner demonstrated the lowest wear penetration at last follow-up and the lowest rate of wear penetration per year. Additionally, the combination of a crosslinked polyethylene (XLPE) liner and a zircon oxide (ZrO 2 ) head demonstrated the lowest rate of revision at last follow-up. These findings underscore the importance of careful material selection for hip implant bearing surfaces to optimize their longevity and patient satisfaction after THA., (© 2023. The Author(s).)

Published
2023
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36. Real-life safety of Emtricitabine/Tenofovir Alafenamide/Bictegravir.

Author

Squillace N, Ricci E, Maggi P, Taramasso L, Menzaghi B, De Socio GV, Piconi S, Maurizio Celesia B, Orofino G, Sarchi E, Pellicanò GF, Simeone F, Valsecchi L, Bandera A, Cenderello G, Attala L, Angioni G, Falasca K, Cascio A, Bargiacchi O, Di Biagio A, and Bonfanti P

Subjects
Male, Humans, Middle Aged, Female, Emtricitabine adverse effects, Alanine therapeutic use, Heterocyclic Compounds, 3-Ring therapeutic use, Pyridones therapeutic use, Anti-Retroviral Agents therapeutic use, Lipoproteins, HDL, HIV Infections drug therapy, Anti-HIV Agents adverse effects
Abstract

Introduction: Integrase strand transfer inhibitors (INSTI) are one of the most prescribed drug classes for the treatment of HIV infection worldwide. Emtricitabine/Tenofovir Alafenamide/ Bictegravir (FTC/TAF/BIC) has been evaluated in randomized clinical trials; few studies have verified tolerability and safety in clinical practice. Our aim was to investigate the metabolic and hepatic safety in a real-life setting of FTC/TAF/BIC., Materials and Methods: Consecutive people living with HIV infection (PLWH) enrolled in the SCOLTA project, switching to or initiating their first antiretroviral treatment with FTC/TAF/BIC were included. PLWH with HBV co-infection were excluded. Metabolic and hepatic variables were collected at T0 and T1, were defined as baseline and 6-month follow-up respectively, and their modifications were analysed using the paired t-test and the analysis of variance., Results: Five hundred and thirty-nine PLWH with at least one follow-up visit were included in the analysis. Mean age was 48 years (±12.1), 74% were male, 16.1% were naïve to antiretrovirals (ART). At T1, ART-experienced PLWH showed a significant reduction of total cholesterol (TC) and triglycerides, and a slight increase in blood glucose (BG) and ALT. On the contrary, in ART-naïve PLWH blood lipids significantly increased, although with an unaffected TC/high density lipoprotein (HDL)-c ratio, while alanine aminotransferase (ALT) decreased significantly, mainly in those with altered baseline level. The treatment interruptions were 45 (8.4%) over the whole observation period, 13 (2.4%) due to AEs. The most frequent AEs were related to the central nervous system (6 events of depression, insomnia, headache, agitation) and 3 PLWH discontinued the regimen because of grade 1-2 weight gain., Conclusions: In ART-experienced PLWH switching to FTC/TAF/BIC a significant improvement of lipid profile occurred but with significant BG and ALT variation without clinical relevance. In ART-naïve PLWH, blood lipids increased even though lipid profile did not worsen, and a trend towards normalization of liver enzymes was suggested. FTC/TAF/BIC is well tolerated in the real life setting., Competing Interests: “The following authors served as consultant or advisory board and/or received speaker’s fees and/or received research grants for their institutions, outside the present work: PM and GFP from Gilead Science, ViiV Healthcare, Janssen and Merck Sharp & Dohme, PB from Gilead Science, ViiV Healthcare, Janssen, Merck Sharp & Dohme and Pfizer. ADB from Gilead Science, ViiV Healthcare and Janssen. RB from Gilead Science, ViiV Healthcare, and Merck Sharp & Dohme. AC from Gilead Science, Janssen, Merck Sharp & Dohme; NS from ViiV Healthcare, Janssen and Gilead Sciences; LT from ViiV Healthcare and Gilead Science; GVDS from ViiV Healthcare. All remaining authors have no potential conflicts of interest. This does not alter our adherence to PLOS ONE policies on sharing data and materials.”, (Copyright: © 2023 Squillace et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Published
2023
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37. Efficacy and safety of the sofosbuvir/velpatasvir combination for the treatment of patients with early mild to moderate COVID-19.

Author

Messina V, Nevola R, Izzi A, De Lucia Sposito P, Marrone A, Rega R, Fusco R, Lumino P, Rinaldi L, Gaglione P, Simeone F, Sasso FC, Maggi P, and Adinolfi LE

Subjects
Antiviral Agents adverse effects, Carbamates, Case-Control Studies, Disease Progression, Genotype, Hepacivirus genetics, Heterocyclic Compounds, 4 or More Rings adverse effects, Humans, RNA-Dependent RNA Polymerase, SARS-CoV-2, Sofosbuvir, Treatment Outcome, Hepatitis C drug therapy, COVID-19 Drug Treatment
Abstract

SARS-CoV-2 is still a health problem worldwide despite the availability of vaccines. Therefore, there is a need for effective and safe antiviral. SARS-CoV-2 and HCV necessitate RNA-dependent RNA polymerase (RdRp) for replication; therefore, it has been hypothesized that RdRp inhibitors used to treat HCV may be effective treating SARS-CoV-2. Accordingly, we evaluated the effect of the sofosbuvir/velpatasvir (SOF/VEL) combination in early SARS-CoV-2 infection. A multicenter case-control study was conducted, enrolling 120 patients with mild or moderate COVID-19, of whom 30, HCV coinfected or not, received SOF/VEL tablets (400/100 mg) once daily for 9 days within a median of 6 days from the beginning of infection and 90 controls were treated with standard care. The primary endpoint was the effect on viral clearance, and the secondary endpoint was the improvement of clinical outcomes. Nasal swabs for SARS-CoV-2 by PCR were performed every 5-7 days. Between 5-14 days after starting SOF/VEL treatment, SAS-CoV-2 clearance was observed in 83% of patients, while spontaneous clearance in the control was 13% (p < 0.001). An earlier SARS-CoV-2 clearance was observed in the SOF/VEL group than in the control group (median 14 vs 22 days, respectively, p < 0.001) also when the first positivity was considered. None of the patients in the SOF/VEL group showed disease progression, while in the control group, 24% required more intensive treatment (high flow oxygen or noninvasive/invasive ventilation), and one patient died (p < 0.01). No significant side effects were observed in the SOF/VEL group. Early SOF/VEL treatment in mild/moderate COVID-19 seems to be safe and effective for faster elimination of SARS-CoV-2 and to prevent disease progression., (© 2022. The Author(s).)

Published
2022
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38. Dementia as Risk Factor for Severe Coronavirus Disease 2019: A Case-Control Study.

Author

Pisaturo M, Calò F, Russo A, Camaioni C, Giaccone A, Pinchera B, Gentile I, Simeone F, Iodice A, Maggi P, and Coppola N

Abstract

Background: The aim of the present study was to investigate the outcome of patients with SARS-CoV-2 infection and dementia., Patients and Methods: In a multicenter, observational, 1:2 matched case-control study all 23 patients with a history of dementia, hospitalized with a diagnosis of SARS-CoV-2 infection from February 28th 2020 to January 31st 2021 were enrolled. For each Case, 2 patients without dementia observed in the same period study, pair matched for gender, age (±5 years), PaO 2 /FiO 2 (P/F) ratio at admission (<200, or >200), number of comorbidities (±1; excluding dementia) were chosen (Control group)., Results: The majority of patients were males (60.9% of Cases and Controls) and very elderly [median age 82 years (IQR: 75.5-85) in the Cases and 80 (IQR: 75.5-83.75) in the Controls]. The prevalence of co-pathologies was very high: all the Cases and 43 (93.5%) Controls showed a Charlson comorbidity index of at least 2. During hospitalization the patients in the Case group less frequently had a moderate disease of COVID-19 (35 vs. 67.4%, p = 0.02), more frequently a severe disease (48 vs. 22%, p = 0.03) and more frequently died (48 vs. 22%, p = 0.03). Moreover, during coronavirus disease 2019 (COVID-19), 14 (60.8%) patients in the Case group and 1 (2.1%; p < 0.000) in the Control group showed signs and symptoms of delirium., Conclusion: Patients with dementia are vulnerable and have an increased risk of a severe disease and death when infected with COVID-19., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Pisaturo, Calò, Russo, Camaioni, Giaccone, Pinchera, Gentile, Simeone, Iodice, Maggi and Coppola.)

Published
2021
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39. Safety and efficacy of COVID-19 convalescent plasma in severe pulmonary disease: A report of 17 patients.

Author

Pal P, Ibrahim M, Niu A, Zwezdaryk KJ, Tatje E, Robinson WR 4th, Ko L, Satyavarapu I, Jones WE, Nachabe A, Luk A, Mushatt DM, Halvorson K, Denson JL, Smith CC 3rd, Simeone F, Davis G, Gill SK, McDougal A, Vigh AS, Peterson TG, Ning B, Hu T, Socola F, Robinson J, Safah H, and Saba NS

Subjects
Humans, Immunization, Passive, Immunoglobulins, SARS-CoV-2, COVID-19 Serotherapy, COVID-19 therapy, Coronavirus Infections
Published
2021
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40. Hemodynamic variations and pitfalls during venoarterial extracorporeal membrane oxygenation and left ventricular apical unloading as bridge to heart transplantation.

Author

Tsioulpas C, Mandoli GE, Cameli M, Bernazzali S, Pastore MC, Simeone F, Valente S, and Maccherini M

Abstract

Despite the exponential increase in venoarterial extracorporeal membrane oxygenation (VA-ECMO) use during the past decade, adult cardiac ECMO is still accompanied by a high mortality rate. Moreover, although left ventricular distension is now a well-known drawback of VA-ECMO, there seems to be great variability in the hemodynamic management strategies and in the results reported among the various centers. Hemodynamic management of VA-ECMO can be even more challenging when complex configurations are deployed. Here we present and discuss an interesting case of a modified VA-ECMO that although it occurred a few years ago it is instructive for its hemodynamic implications and pitfalls. VA-ECMO can either save the patient or catalyze the deterioration of a compromised clinical condition and thus a close multiparametric monitoring is mandatory especially with complex ECMO arrangements. A thorough understanding of the hemodynamic changes and problems that may occur during these cases is necessary too. Ultimately, critical thinking along with a proactive approach for early referral to more specialized centers and immediate unloading of the left ventricle whenever it is deemed necessary, together may contribute to reduce the relatively high mortality rate with this type of support. < Learning objective: Venoarterial extracorporeal membrane oxygenation (VA-ECMO) can either save the patient or catalyze the deterioration of a compromised clinical condition if support-related drawbacks are not correctly identified and promptly adjusted. Management of complex VA-ECMO configurations can be challenging and thus a thorough understanding and close multiparametric monitoring of the hemodynamic implications and pitfalls are necessary in order to prevent negative outcomes.>., Competing Interests: The authors declare that there are no conflicts of interest., (© 2021 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.)

Published
2021
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41. Dangerous liaisons? The role of inflammation and comorbidities in HIV and SARS-CoV-2 infection.

Author

Maggi P, Ricci E, Messina V, Salzillo A, Simeone F, Iodice A, and Socio GV

Subjects
Blood Coagulation Disorders epidemiology, Blood Coagulation Disorders immunology, Comorbidity, Cytokines immunology, Diabetes Mellitus epidemiology, Diabetes Mellitus immunology, Humans, Hyperglycemia epidemiology, Hyperglycemia immunology, Hypertension epidemiology, Hypertension immunology, Inflammation, Metabolic Syndrome epidemiology, Metabolic Syndrome immunology, SARS-CoV-2, COVID-19 epidemiology, COVID-19 immunology, HIV Infections epidemiology, HIV Infections immunology
Abstract

Introduction: In people living with HIV (PLWH), immune activation and inflammation levels are high even when viral suppression is maintained, potentially contributing to several comorbidities, and hampering the immune response to infections such as the recent SARS-CoV-2 disease 2019 (COVID-19)., Areas Covered: Immune activation and inflammation play a role in SARS-CoV-2 infection. Severe COVID-19 patients may experience cytokine release syndrome (CRS), leading to alveolar damage, pulmonary fibrinolysis, dysregulated coagulation, and pulmonary injury. Into the systemic circulation, cytokines in excess might leak out of pulmonary circulation, causing systemic symptoms and possibly a multiple-organ dysfunction syndrome. Preexisting comorbidities are also linked to worse COVID-19 outcome: studies suggest that diabetes and hypertension are linked to higher mortality rates. Such comorbidities are more frequent in PLWH, but it is unclear if they have worse outcomes in the case of COVID-19. The literature was searched in PubMed/MEDLINE and EMBASE, and manually in COVID-19 resources., Expert Opinion: A body of evidence shows that HIV and SARS-CoV-2 are able to activate inflammatory pathways, acute in the case of SARS-CoV-2, chronic in the case of HIV, while the comorbidities seem to represent, in the first case, a contributory cause, in the second an effect of the virus-induced damage.

Published
2021
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42. Directly Acting Antiviral-Based Treatment for HCV-Infected Persons Who Inject Drugs: A Multicenter Real-Life Study.

Author

Messina V, Onorato L, Di Caprio G, Claar E, Iovinella V, Russo A, Rosato V, Salzillo A, Nevola R, Simeone F, Curcio F, Pisaturo M, and Coppola N

Abstract

Background: We aimed to evaluate the factors associated with a virological response in a cohort of Hepatitis C virus (HCV)-infected people who inject drugs (PWID) treated with direct acting antivirals (DAAs)., Methods: We conducted a multicenter retrospective cohort study enrolling HCV-infected PWID treated with DAAs. The primary outcome evaluated was the sustained virological response (SVR12) rate., Results: Five hundred and twenty HCV-infected PWID treated with all-oral DAA-based regimens were enrolled; a total of 168 (32.3%) patients presented genotype 1a, 109 (21.0%) genotype 1b, and 174 (33.5%) genotype 3; a total 152 of the 520 subjects (29.2%) were cirrhotics; a total 118 (22.7%) and 373 (71.7%) were treated with DAA regimens of second and third generation, respectively; a total 169 (33.6%) patients were receiving an opioid agonist at the start of antiviral therapy. Only 11 subjects (2.1%) did not show an SVR12. A significant correlation was found between treatment with opioid substitution therapy ( p < 0.001), Human Immunodeficiency Virus (HIV) coinfection ( p = 0.002), and treatment with first- or second-generation regimens ( p = 0.0015) and HCV failure. Upon multivariate analysis, treatment with a first- or second-generation DAA was the only factor independently associated with failure (OR 10.4, 95% CI: 1.43 to 76.1, p = 0.02)., Conclusions: Treatment with DAAs led to a high SVR12 rate (97.9%) in a large cohort of HCV-infected PWID. The only predictor of viral failure found in our analysis was treatment with first- and second-generation DAA.

Published
2020
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43. Innovative procedures for micro-elimination of HCV infection in persons who use drugs.

Author

Messina V, Russo A, Parente E, Russo G, Raimondo T, Salzillo A, Simeone F, Onorato L, Di Caprio G, Pisaturo M, and Coppola N

Subjects
Antiviral Agents therapeutic use, Humans, Prospective Studies, Hepatitis C drug therapy, Hepatitis C epidemiology, Hepatitis C prevention & control, Pharmaceutical Preparations, Substance Abuse, Intravenous drug therapy
Abstract

People who use drugs are a key population in global HCV control. We evaluated the efficacy of an innovative model to eliminate HCV infection in a high-risk population of PWUD in a service for substance use disorder (SUD). Between January 2018 and December 2018, we conducted a prospective, interventional, before and after study, based on audits performed by Infectious Diseases physicians in a SUD facility in Piedimonte Matese, in southern Italy, to improve the knowledge about HCV infection; a shared protocol for screening and linkage to care of patients was implemented. The pre-intervention period was defined as January-December 2017 and the post-intervention period as January-December 2018. The subjects followed up at SUD facility in the pre-intervention and post-intervention periods were 318 and 275, respectively. Compared with the pre-intervention period, the number of anti-HCV-positive subjects tested for HCV RNA was higher in the post-intervention period (91% vs 27%, P < .0001), as was the number who started directly acting antivirals (DAAs). Of the 18 HCV RNA-positive subjects in the pre-intervention period, only 3 (16.6%) started DAA, a percentage decisively lower than that observed after the start of the programme, 63 (84%) of 75 subjects (P < .0001), and all obtained SVR. The data were similar for people who inject drugs (PWID) and non-PWID sub-populations. The use of our innovative model with close interaction between the Infectious Disease Unit and the SUD facility determined a significant increase in HCV RNA testing, linkage to care and the start of DAA in the PWUD population., (© 2020 John Wiley & Sons Ltd.)

Published
2020
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44. DAA-based treatment for HIV-HCV-coinfected patients: analysis of factors of sustained virological response in a real-life study.

Author

Alessio L, Onorato L, Sangiovanni V, Borrelli F, Manzillo E, Esposito V, Simeone F, Martini S, Capoluongo N, Leone S, Di Filippo G, D'Abbraccio M, Aprea L, Megna AS, Milano E, Rizzo V, Saracino A, and Coppola N

Subjects
Adult, Antiviral Agents pharmacology, Antiviral Agents therapeutic use, Drug Resistance, Viral, Genotype, Hepacivirus genetics, Humans, Retrospective Studies, Viral Nonstructural Proteins genetics, Coinfection drug therapy, HIV Infections complications, HIV Infections drug therapy, Hepatitis C, Chronic complications, Hepatitis C, Chronic drug therapy
Abstract

Background: The aim of the present study was to evaluate in HIV-infected patients treated with a direct-acting antiviral agent (DAA)-based regimen the variables associated with sustained virological response (SVR) and the trend in biochemical parameters and clinical events during and after DAA regimen., Methods: We performed a multicentre retrospective cohort study, enrolling all 243 HIV-HCV-coinfected adult patients treated with DAAs between January 2015 and December 2018 in one of the nine participating Infectious Disease Centers in southern Italy, eight in Campania and one in Apulia., Results: Of the 243 patients enrolled, 233 (95.9%) obtained an SVR at 12 weeks (SVR12). Of the 10 patients with non-SVR, 7 were tested for NS3, NS5A and NS5B resistance-associated substitutions (RASs) by sequencing analysis and 6 showed at least 1 major RAS in 1 HCV region (all in NS5A, 2 in NS5B and 1 in NS3). Comparing the 233 patients achieving SVR and the 10 non-achievers, no variable was independently associated with non-SVR. During and after DAA regimen, no modification in the biochemical parameters and clinical events was observed; however, the serum cholesterol and low-density lipoprotein (LDL) levels showed an increase (from 159 ±41.3 mg/dl at baseline to 174 ±44.5 mg/dl at week 12 after stopping treatment, P<0.001, and from 92 ±34.6 mg/dl to 109.4 ±73.7 mg/dl, P=0.002, respectively)., Conclusions: The treatment with DAAs led to a high SVR12 rate in HIV-HCV-coinfected subjects, irrespective of epidemiological, clinical or virological characteristics. However, the DAA regimen was associated with an increase in total- and LDL-cholesterol, to be taken into account in the management of HIV infection.

Published
2020
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45. Patient blood management in cardiac surgery: The "Granducato algorithm".

Author

Scolletta S, Simioni P, Campagnolo V, Celiento M, Fontanari P, Guadagnucci A, Guarracino F, Haxhiademi D, Paniccia R, Simeone F, and Ranucci M

Subjects
Aged, Female, Follow-Up Studies, Humans, Italy, Male, Middle Aged, Retrospective Studies, Algorithms, Blood Loss, Surgical prevention & control, Blood Transfusion methods, Cardiac Surgical Procedures methods
Abstract

Background: Patients undergoing cardiac surgery are subject to severe alterations of the coagulation system. The four cardiac surgery centers in Tuscany (Italy) structured and shared an algorithm (Granducato Patient Blood Management algorithm, G-PBMa) with predefined interventions for patient blood management. The aim of the study is to analyze the impact of that algorithm on the transfusion needs and bleeding-related outcomes in a large patient population., Methods: Multicenter retrospective observational study on 3839 patients undergoing cardiac surgery at the four cardiac centers in Tuscany. The G-PBMa was released at the end of 2015 and it was structured in three parts: pre-, intra-, and post-operative. The year 2014, before the G-PBMa (1955 patients) and the year 2016 (1884 patients) after the G-PBMa in place were compared. Logistic regression analyses were used., Results: The main changes introduced were the routine application of viscoelastic tests in bleeding patients (+72%) and the use of fibrinogen and prothrombin complex concentrate (+67%). The G-PBMa resulted in a significant reduction in the overall transfusion rate and in the transfusion rate of the separate blood products (relative risk for transfusions: 0.75, 95% confidence interval 0.65-0.85, P = 0.001). For preoperative hemoglobin values of between 8 and 10 g/dL, the absolute difference in RBC transfusion rate before and after the G-PBMa introduction ranged around 15%-17%. The G-PBMa introduction determined lower (P = 0.02) chest drain blood loss, lower (P = 0.001) postoperative acute kidney injury and shorter (P = 0.001) hospital stay., Conclusions: The G-PBMa was effective in reducing blood loss, transfusion requirements, and resulted in a better outcome., (Copyright © 2019. Published by Elsevier B.V.)

Published
2019
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46. ☆ Diagnostic and therapeutic injections of the foot and ankle-An overview.

Author

de Cesar Netto C, da Fonseca LF, Simeone Nascimento F, O'Daley AE, Tan EW, Dein EJ, Godoy-Santos AL, and Schon LC

Subjects
Anesthetics, Local administration & dosage, Foot Diseases drug therapy, Glucocorticoids administration & dosage, Humans, Pain etiology, Pain Management, Ankle, Ankle Joint, Foot, Foot Diseases diagnosis, Foot Diseases therapy, Injections methods
Abstract

Foot and ankle injections are useful diagnostic and therapeutic tools, particularly when the pain etiology is uncertain. A variety of foot and ankle injuries and pathologies, including degenerative joint disease, plantar fasciitis and different tendinopathies are amenable to injections. Understanding the foot and ankle anatomical landmarks, a thorough physical exam and knowledge of the different injection techniques is key for a successful approach to different pathologies. The objective of this study is to review the use of foot and ankle injections in the orthopaedic literature, present the readers with the senior author's experience and provide a comprehensive clinical guideline to the most common foot and ankle diagnostic and therapeutic injections., (Copyright © 2017 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.)

Published
2018
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47. Continuous monitoring of noise levels in the Gulf of Catania (Ionian Sea). Study of correlation with ship traffic.

Author

Viola S, Grammauta R, Sciacca V, Bellia G, Beranzoli L, Buscaino G, Caruso F, Chierici F, Cuttone G, D'Amico A, De Luca V, Embriaco D, Favali P, Giovanetti G, Marinaro G, Mazzola S, Filiciotto F, Pavan G, Pellegrino C, Pulvirenti S, Simeone F, Speziale F, and Riccobene G

Subjects
Acoustics, Water, Environmental Monitoring, Noise, Ships
Abstract

Acoustic noise levels were measured in the Gulf of Catania (Ionian Sea) from July 2012 to May 2013 by a low frequency (<1000Hz) hydrophone, installed on board the NEMO-SN1 multidisciplinary observatory. NEMO-SN1 is a cabled node of EMSO-ERIC, which was deployed at a water depth of 2100m, 25km off Catania. The study area is characterized by the proximity of mid-size harbors and shipping lanes. Measured noise levels were correlated with the passage of ships tracked with a dedicated AIS antenna. Noise power was measured in the frequency range between 10Hz and 1000Hz. Experimental data were compared with the results of a fast numerical model based on AIS data to evaluate the contribution of shipping noise in six consecutive 1/3 octave frequency bands, including the 1/3 octave frequency bands centered at 63Hz and 125Hz, indicated by the Marine Strategy Framework Directive (2008/56/EC)., (Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Published
2017
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48. Long-Term Monitoring of Dolphin Biosonar Activity in Deep Pelagic Waters of the Mediterranean Sea.

Author

Caruso F, Alonge G, Bellia G, De Domenico E, Grammauta R, Larosa G, Mazzola S, Riccobene G, Pavan G, Papale E, Pellegrino C, Pulvirenti S, Sciacca V, Simeone F, Speziale F, Viola S, and Buscaino G

Subjects
Animals, Ecosystem, Mediterranean Sea, Moon, Seasons, Sound Spectrography, Spatio-Temporal Analysis, Acoustics, Dolphins, Vocalization, Animal
Abstract

Dolphins emit short ultrasonic pulses (clicks) to acquire information about the surrounding environment, prey and habitat features. We investigated Delphinidae activity over multiple temporal scales through the detection of their echolocation clicks, using long-term Passive Acoustic Monitoring (PAM). The Istituto Nazionale di Fisica Nucleare operates multidisciplinary seafloor observatories in a deep area of the Central Mediterranean Sea. The Ocean noise Detection Experiment collected data offshore the Gulf of Catania from January 2005 to November 2006, allowing the study of temporal patterns of dolphin activity in this deep pelagic zone for the first time. Nearly 5,500 five-minute recordings acquired over two years were examined using spectrogram analysis and through development and testing of an automatic detection algorithm. Echolocation activity of dolphins was mostly confined to nighttime and crepuscular hours, in contrast with communicative signals (whistles). Seasonal variation, with a peak number of clicks in August, was also evident, but no effect of lunar cycle was observed. Temporal trends in echolocation corresponded to environmental and trophic variability known in the deep pelagic waters of the Ionian Sea. Long-term PAM and the continued development of automatic analysis techniques are essential to advancing the study of pelagic marine mammal distribution and behaviour patterns.

Published
2017
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49. A 24-Hour Postintensive Care Unit Transition-of-Care Model Shortens Hospital Stay.

Author

Kheir F, Shawwa K, Nguyen D, Alraiyes AH, Simeone F, and Nielsen ND

Subjects
Critical Illness rehabilitation, Female, Humans, Male, Middle Aged, Patient Discharge, Patient Transfer, Retrospective Studies, Critical Illness therapy, Intensive Care Units organization & administration, Length of Stay statistics & numerical data, Transitional Care organization & administration
Abstract

Background: Patients discharged early from the medical intensive care unit (MICU) are at risk of deterioration, MICU readmission, and increased mortality. An earlier discharge to a medical ward is desirable to reduce costs but it may adversely affect outcomes. To address this problem, a new model for the MICU transition of care was implemented at our academic center: The MICU team continued to manage all patients transferred from the MICU to the medical ward for at least 24 hours., Methods: Data were collected for all MICU patients admitted 1 year before and 1 year after the intervention. Hospital length of stay (LOS) after transfer from the MICU, readmission rate, and mortality rate were compared before and after the intervention. A nonparsimonious propensity model based on 30 factors was used to identify matched preintervention and postintervention cohorts., Results: A total of 618 of the 848 patients admitted to the MICU were transferred to medical ward during the year prior to the implementation of the new model, and 600 of the 883 patients were transferred during the following year. Pre- and postintervention cohorts were well matched (n = 483 patients in each group). Poisson regression analysis showed a decrease in the hospital LOS after MICU transfer by 1.17 days (P < .001) without a significant change in adjusted mortality (lower by 1.9%, P = .181) and MICU readmission rates (lower by 2%, P = .264)., Conclusion: A new model for the post-MICU transition of care, with the MICU team continuing to manage all patients transferred to the medical ward for at least 24 hours, significantly decreased duration of hospital stay after MICU transfer without affecting MICU readmission and mortality rate. The implementation of this model may lower medical costs and make transition of care safer without adverse outcomes., (© The Author(s) 2015.)

Published
2016
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50. Boceprevir or telaprevir in hepatitis C virus chronic infection: The Italian real life experience.

Author

Cleo Study Group, Ascione A, Adinolfi LE, Amoroso P, Andriulli A, Armignacco O, Ascione T, Babudieri S, Barbarini G, Brogna M, Cesario F, Citro V, Claar E, Cozzolongo R, D'Adamo G, D'Amico E, Dattolo P, De Luca M, De Maria V, De Siena M, De Vita G, Di Giacomo A, De Marco R, De Stefano G, De Stefano G, Di Salvo S, Di Sarno R, Farella N, Felicioni L, Fimiani B, Fontanella L, Foti G, Furlan C, Giancotti F, Giolitto G, Gravina T, Guerrera B, Gulminetti R, Iacobellis A, Imparato M, Iodice A, Iovinella V, Izzi A, Liberti A, Leo P, Lettieri G, Luppino I, Marrone A, Mazzoni E, Messina V, Monarca R, Narciso V, Nosotti L, Pellicelli AM, Perrella A, Piai G, Picardi A, Pierri P, Pietromatera G, Resta F, Rinaldi L, Romano M, Rossini A, Russello M, Russo G, Sacco R, Sangiovanni V, Schiano A, Sciambra A, Scifo G, Simeone F, Sullo A, Tarquini P, Tundo P, and Vallone A

Abstract

Aim: To check the safety and efficacy of boceprevir/telaprevir with peginterferon/ribavirin for hepatitis C virus (HCV) genotype 1 in the real-world settings., Methods: This study was a non-randomized, observational, prospective, multicenter. This study involved 47 centers in Italy. A database was prepared for the homogenous collection of the data, was used by all of the centers for data collection, and was updated continuously. All of the patients enrolled in this study were older than 18 years of age and were diagnosed with chronic infection due to HCV genotype 1. The HCV RNA testing was performed using COBAS-TaqMan2.0 (Roche, LLQ 25 IU/mL)., Results: All consecutively treated patients were included. Forty-seven centers enrolled 834 patients as follows: Male 64%; median age 57 (range 18-78), of whom 18.3% were over 65; mean body mass index 25.6 (range 16-39); genotype 1b (79.4%); diagnosis of cirrhosis (38.2%); and fibrosis F3/4 (71.2%). The following drugs were used: Telaprevir (66.2%) and PEG-IFN-alpha2a (67.6%). Patients were naïve (24.4%), relapsers (30.5%), partial responders (14.8%) and null responders (30.3%). Overall, adverse events (AEs) occurred in 617 patients (73.9%) during the treatment. Anemia was the most frequent AE (52.9% of cases), especially in cirrhotic. The therapy was stopped for 14.6% of the patients because of adverse events or virological failure (15%). Sustained virological response was achieved in 62.7% of the cases, but was 43.8% in cirrhotic patients over 65 years of age., Conclusion: In everyday practice, triple therapy is safe but has moderate efficacy, especially for patients over 65 years of age, with advanced fibrosis, non-responders to peginterferon + ribavirin.

Published
2016
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